Psychological flexibility is associated with less diabetes distress and lower glycated haemoglobin in adults with type 1 diabetes

Background Diabetes distress, self‐efficacy and health literacy are associated with diabetes self‐management and health outcomes. Measures of coping styles and their impact on diabetes self‐management and diabetes‐related distress might add value in identifying those at risk of poorer health outcomes. Current evidence of associations between psychological flexibility/inflexibility and diabetes‐related health outcomes is limited. Aims To measure associations of psychological flexibility, self‐efficacy and health literacy with diabetes distress and glycated haemoglobin (HbA1c) in adults with type 1 diabetes. Methods We surveyed 105 adults with type 1 diabetes attending a tertiary diabetes outpatient clinic (mean age 27 ± 7.1 years; 53% men; duration of diabetes 12.6 ± 8.5 years; HbA1c 72 ± 22 mmol/mol, 8.7 ± 2.0%; 34% using insulin pumps). We assessed psychological flexibility, self‐efficacy, health literacy and diabetes distress. Regression models explored the relative contributions of different factors to diabetes distress and HbA1c. Results The majority of health literacy scores were in the low‐risk range. Those with greater psychological flexibility had higher self‐efficacy (r = 0.34; P