Comparing the Effects of Diabetes-Specific and Overall Medication Regimen Complexity on Diabetes Distress

The Science of Diabetes Self-Management and Care

Kaye Min Teo, MD, Ryan J. Shaw, PhD, RN, Anastasia-Stefania Alexopoulos, MBBS, MHS, Gina Pennington Daniel Hatch, PhD, Qing Yang, PhD, Matthew J. Crowley, MD

Plot of interrater reliability for diabetes-specific Medication Regimen Complexity Index.

Summary

Purpose:

The purpose of this study was to examine the association between diabetes-specific and overall medication regimen complexity and diabetes distress among adults with type 2 diabetes.

Methods:

This study examined data from 220 patients with type 2 diabetes and hypertension and persistently elevated A1C, who were recruited for a remote monitoring-enabled telehealth trial (Clinicaltrials.gov NCT05120544). Chart review was performed to obtain prescription data to determine medication regimen complexity using the validated medication regimen complexity index. Multiple regression models were used to investigate the link between regimen complexity and Diabetes Distress Scale and subscale scores, adjusting for sociodemographic variables and comorbidities.

Results:

Study sample was 64% women, 68% Black, with a mean age of 54.5. The mean A1C was 9.8% (84 mmol/mol), and 63% reported moderate to high distress. The study population was prescribed a mean of 2.9 diabetes medications and 11.5 overall long-term medications. The mean diabetes-specific and overall Medication Regimen Complexity Index were 11.5 and 30.2, respectively. No statistically significant associations between diabetes-specific or overall medication regimen complexity and diabetes distress were identified. Overall medication regimen complexity was negatively associated with regimen-related diabetes distress. Medication regimen complexity did not significantly impact the association between diabetes distress and A1C.

Conclusions:

Participants with high overall medication regimen complexity had lower regimen-related diabetes distress. Further studies are needed to evaluate associations between medication regimen complexity and diabetes distress while ensuring sufficient statistical power.

Citation

Min, Teo Kaye, et al. “Comparing the Effects of Diabetes-Specific and Overall Medication Regimen Complexity on Diabetes Distress.” The Science of Diabetes Self-Management and Care (2026): 26350106261422676.

BibTex

@article{min2026comparing, title={Comparing the Effects of Diabetes-Specific and Overall Medication Regimen Complexity on Diabetes Distress}, author={Min, Teo Kaye and Shaw, Ryan J and Alexopoulos, Anastasia-Stefania and Pennington, Gina and Hatch, Daniel and Yang, Qing and Crowley, Matthew J}, journal={The Science of Diabetes Self-Management and Care}, pages={26350106261422676}, year={2026}, publisher={SAGE Publications Sage CA: Los Angeles, CA} }

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