Diabetes research and clinical practice · 2026
Exploring key targets for psychodiabetological interventions in adults with type 1 diabetes mellitus: an exploratory network and intervention modeling study using Polish MyDiaMate data.
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Cyranka Katarzyna, Klupa Tomasz, Matejko Bartłomiej, Juryk Andrzej, Klasa Katarzyna, Snoek Frank, Dudek Dominika, Małecki Maciej T, Sobański Jerzy A
Аннотация
AIMS: To examine the symptom-level structure of diabetes-related psychological burden in adults with Type 1 diabetes mellitus using selected cross-sectional data from Polish MyDiaMate users, and to identify model-implied intervention targets.
METHODS: We analyzed anonymized app-derived records from 101 active users with complete data on 15 binary reflective items using bootstrapped undirected network modeling, Bayesian directed modeling, and intervention simulation.
RESULTS: The most frequently endorsed items concerned future complications (85.1%), guilt or worry when diabetes was out of control (79.2%), diabetes burnout (72.3%), and feeling that diabetes controls one's life (72.3%). Network modeling revealed a densely connected psychological-burden domain and a more compact fatigue-somatic domain. Directed modeling suggested a pathway from diabetes-related anxiety to perceived loss of control, burnout, and guilt, with subsequent links to reduced perceived coping with complications and worry about future complications. Anxiety showed the largest modeled downstream influence, whereas perceived loss of agency appeared to be a more local intervention target.
CONCLUSIONS: Diabetes-related anxiety and perceived loss of agency emerged as potentially relevant, model-implied intervention targets. These exploratory findings require validation in longitudinal and interventional studies.
METHODS: We analyzed anonymized app-derived records from 101 active users with complete data on 15 binary reflective items using bootstrapped undirected network modeling, Bayesian directed modeling, and intervention simulation.
RESULTS: The most frequently endorsed items concerned future complications (85.1%), guilt or worry when diabetes was out of control (79.2%), diabetes burnout (72.3%), and feeling that diabetes controls one's life (72.3%). Network modeling revealed a densely connected psychological-burden domain and a more compact fatigue-somatic domain. Directed modeling suggested a pathway from diabetes-related anxiety to perceived loss of control, burnout, and guilt, with subsequent links to reduced perceived coping with complications and worry about future complications. Anxiety showed the largest modeled downstream influence, whereas perceived loss of agency appeared to be a more local intervention target.
CONCLUSIONS: Diabetes-related anxiety and perceived loss of agency emerged as potentially relevant, model-implied intervention targets. These exploratory findings require validation in longitudinal and interventional studies.