Introduction
diabetes, Diabetes Distress
TYPE 2 DIABETES, DIABETES
Clinical trials demonstrate lower morbidity and mortality in patients with type 2 diabetes by reducing hemoglobin AThe Diabetes Distress Scale–17 (DDS-17) is an established, validated measure with 17 items to assess the level of distress in patients with diabetes.We previously developed Empowering Patients in Chronic Care (EPICC) and described its value in a series of studies.In this study, we establish the distribution-based MCIDs for DDS-17 and each of the 4 subscales of the DDS-17 using a quantitative calculation translated into 3 categories of change in DDS-17 scores: improvement, no change, and worsening. We then compare the percentage identified in each MCID category relative to the percentage of participants defined as changing based on crossing over the established DDS-17 cutpoint of 2.0. We also examined associations of MCID categories with participation in the EPICC treatment group and change in HbA