{
  "abstract": "Objectives Using network analysis, which takes a holistic approach to health systems, we aimed to identify which psychosocial burden dimensions are the most central and, thus, critical to prioritising to improve the overall health of people with type 1 diabetes (PwT1D).Design A cross-sectional network analysis.Setting We used data from participants attending 44 diabetes centres in France, who were enrolled in the SFDT1 cohort study between June 2020 and February 2024.Participants We included 1430 PwT1D (52% women, median age (IQR) 41 (31–52.8) years) who had completed questionnaires on diabetes burden.Outcome measures The items from questionnaires on diabetes distress, fear of hypoglycaemia, quality of life, treatment burden and the impact of diabetes on education and work.Results The network was highly stable (correlation stability coefficient=0.75). We observed nine domains within the network; ‘Loneliness, Worrying & Burnout’ was the most influential. We further grouped the domains into three distinct syndromes labelled ‘Diabetes Distress’, ‘Treatment Burden’ and ‘Impact of Diabetes on Life’. These syndromes reflect the most relevant pillars of the psychosocial burden in PwT1D.Conclusions We observed that ‘Loneliness, Worrying & Burnout’ is the most influential psychosocial burden network domain to prioritise for type 1 diabetes care. This new network-based approach opens the path to defining personalised interventions targeting the most critical burden parameters to expect the most significant overall beneficial impact on PwT1D’s health.Trial registration number NCT04657783.",
  "authors": [
    {
      "affiliations": [
        "Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg"
      ],
      "name": "Gloria A Aguayo"
    },
    {
      "affiliations": [
        "Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg"
      ],
      "name": "Vincent P Martin"
    },
    {
      "affiliations": [
        "Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg",
        "Faculty of Science Technology and Medicine, University of Luxembourg, Esch-sur-Alzette, Luxembourg"
      ],
      "name": "Dulce Canha"
    },
    {
      "affiliations": [
        "Department of Endocrinology-Diabetology-Nutrition, AP-HP, Paris, France",
        "Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Université Sorbonne Paris Nord, Villetaneuse, France"
      ],
      "name": "Emmanuel Cosson"
    },
    {
      "affiliations": [
        "Département d’Endocrinologie, Centre Hospitalier Bretagne Atlantique, Vannes, France"
      ],
      "name": "Gwenaelle Arnault"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Diabetology, and Nutrition, Centre Hospitalier Aix en Provence, Aix en Provence, France"
      ],
      "name": "Blandine Delenne"
    },
    {
      "affiliations": [
        "Department of Endocrinology, Diabetology, and Nutrition, University of Lorraine, Nancy, France"
      ],
      "name": "Bruno Guerci"
    },
    {
      "affiliations": [
        "American Memorial Hospital, Reims, France"
      ],
      "name": "Aurélie Berot"
    },
    {
      "affiliations": [
        "Endocrinology Diabetes Nutrition Department, CRESTIC, Reims, France"
      ],
      "name": "Sara Barraud"
    },
    {
      "affiliations": [
        "IMMEDIAB Laboratory, Institut Necker Enfants Malades, Paris, France",
        "Centre Universitaire de Diabétologie et de ses Complications, Hôpital Lariboisière, Paris, France"
      ],
      "name": "Jean-Pierre Riveline"
    },
    {
      "affiliations": [
        "Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg"
      ],
      "name": "Guy Fagherazzi"
    }
  ],
  "title": "Psychosocial burden in type 1 diabetes: a cross-sectional network analysis in the SFDT1 study",
  "uid": "3d013eb7-fd6e-57f4-a5a0-225edbbd4665"
}