Psychosocial resilience contributes to better glycaemic control in people living with type 1 diabetes

Background: Previous research in young adults living with type 1 diabetes has shown that psychosocial resilience is associated with lower HbA1c, but it is possible that for type 1 patients this advantage is confounded by higher residual insulin levels in some patients, helping to make glycaemic control easier for this group of patients.
Methods: As part of a prospective study (StartRight; n=480), the CD-RISC 10-item resilience questionnaire scale was completed by 141 participants with type 1 diabetes with 2-12 months diabetes duration (mean duration=7.0 (SD 3.3) months; age 36.8 (13.6) years; males 57%). Regression analysis was carried out on those with c-peptide≥200pmol/l, a reliable indicator of a patient‘s residual insulin release.
Results: Resilience levels were high in this cohort (M=29.8; SD=7.0); the scale ranges from 0 to 40 (very low to very high resilience). In our regression model which adjusted for c- peptide and age as co-variates, stronger resilience was associated with lower HbA1c values (b=-0.53, p=0.02). The association of c-peptide with lower HbA1c values did not reach significance (b=-0.005, p=0.08), nor did age (b=0.12, p=0.10).
Conclusions: Stronger psychosocial resilience which tends to increase weakly with age is associated with better glycaemic control in adults with recently diagnosed type 1 diabetes and c-peptide levels above 200pmol/l. This finding is important in that resilience is linked to glucose control, independently of residual insulin levels, as demonstrated by our adjusted model. Follow-up data will provide further insight into the role of resilience, in relation to progressively reducing c-peptide levels, indicating reducing insulin release.