The interconnectedness between symptoms of fatigue, diabetes distress and emotional well-being in people with type 1 diabetes: A network analysis approach

Living with type 1 diabetes (T1D) can significantly affect emotional well-being, often involving fatigue, diabetes-related distress, and depressive symptoms. This study examined relationships between fatigue, diabetes distress, and emotional well-being in adults with T1D, employing network analysis. We used baseline data from a survey of a web-based, self-guided mental health intervention. Participants were recruited via diabetes organization websites, social media, and healthcare professionals. Fatigue (CIS-F), diabetes distress (PAID-11), and emotional well-being (WHO-5) were measured with validated questionnaires. Network analysis examined symptom-level connections within and between constructs. Among 319 participants (mean age = 43.0, 64.6% female), most reported severe fatigue (53.9%), elevated diabetes distress (71.2%), and low emotional well-being (58.9%). Strong internal connections were found within each construct, but with few links between constructs. No consistent connections emerged between fatigue and diabetes distress. Fatigue, diabetes distress, and emotional well-being appear to function largely independently in the current sample of adults with T1D.