Temporal dynamics of daily diabetes-specific burdens using intensive longitudinal data: the central role of feelings of guilt within a multilevel network analysis
Authors' conclusion
The results provide evidence of how daily diabetes-specific burdens can accumulate and potentially affect the course of emotional well-being. Feeling guilty regarding diabetes self-management may play a central role and represent an important clinical target as well as outcome.
Study context
- Population
- People with T1D and T2D; 50.1% with T2D, 50.7% male, mean age 50.4±14.2 years, HbA1c 65±18.6 mmol/mol (8.1±1.7%)
- Participants
- 741 people3 studies
- Outcome
- Within-person temporal networks of nine daily diabetes-specific burdens
Methodological detailsecological momentary assessment, intensive longitudinal data, multilevel vector autoregression network analysis, up to 17 days
- Ecological momentary assessment
- Intensive longitudinal data
- Multilevel vector autoregression network analysis
- Up to 17 days
Pooled result
As reported in the abstract
- T1D: guilt on one day → 'feeling alone' next day
- β=0.09, p<0.001
- T1D: guilt → 'feeling overwhelmed' next day
- β=0.05, p=0.016
- T1D: guilt → 'feeling restricted' next day
- β=0.05, p=0.015
- T1D: guilt → 'feeling burdened by hyperglycaemia' next day
- β=0.05, p=0.030
- T2D: 'feeling alone' previous day → guilt
- β=−0.07, p=0.016
- T2D: 'feeling burdened by hypoglycaemia' previous day → guilt
- β=0.04, p=0.017
Further pooled results
Higher individual network density and incident elevated diabetes distress and depressive symptoms at follow-up
- Incident elevated diabetes distress
- OR 1.50, p=0.025
- Incident depressive symptoms
- OR 2.08, p<0.001
- Most relevant predictors: 'feelings of guilt' and 'feeling restricted'
Original publication
Temporal dynamics of daily diabetes-specific burdens using intensive longitudinal data: the central role of feelings of guilt within a multilevel network analysis. Diabetologia. Published 21 September 2026. doi:10.
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