Abstract
<jats:p><p dir="ltr">Objectives: Diabetes-dependent quality of life (DDQoL) is a salient health outcome for young adults (YAs) with type 1 diabetes (T1D), shaped by diabetes distress (DD) and social support. The cross-sectional analysis is to examine (1) how DD subtypes relate to DDQoL, (2) whether online support is associated with DDQoL, and (3) whether online support moderates the relationship between DD and DDQoL. Research Design and Methods: We analyzed baseline data from a clinical trial of YAs with T1D (ages 18–30, diabetes duration >1 year, HbA1c ≥7.5%). Participants completed the Diabetes Distress Scale (DDS), the Audit of Diabetes-Dependent Quality of Life (ADDQoL), and a study-designed questionnaire on online support. Univariate and multivariate linear regressions were conducted. Results: Among 209 YAs (66% female, 24.3±3.7 years, 42.6% Hispanic/Latinx), higher total DD and subscale scores were significantly associated with poorer DDQoL (average weighted impact score; p <0.001), with emotional distress showing the strongest negative association (Est.std = –0.60, p <0.001). Online support was also associated with lower DDQoL (Est.std =-0.17, p =0.016). In the adjusted model, online support moderated the impact of interpersonal distress on DDQoL (Interaction Est.std = 0.23, p =0.026). Female gender was associated with better DDQoL (Est.std =0.14, p =0.031) and confounded key associations. Conclusions: These findings revealed the differential associations between DD subtypes and DDQoL and the moderating role of online support in reducing the negative impact of interpersonal distress, underscoring the need for interventions targeting emotional distress and optimizing online support for YAs with T1D. Article Highlights · Why did we undertake this study? We undertook this study because diabetes distress and social support shape diabetes-dependent quality of life (DDQoL) in young adults with type 1 diabetes (T1D), yet the role of distress subtypes and online support is unclear. · What is the specific question(s) we wanted to answer? We asked how diabetes distress subtypes relate to DDQoL, whether online support is associated with DDQoL, and whether online support moderates distress-DDQoL associations. · What did we find? We found that higher distress across subtypes is associated with poorer DDQoL, with emotional distress showing the strongest negative association, and online support moderating the interpersonal distress-DDQoL association. · What are the implications of our findings? These findings suggest prioritizing emotional distress in interventions and optimizing online support to protect DDQoL among the population.</p></jats:p>