Tracking psychosocial outcomes in routine T1D care
Per Winterdijk, Pim Dekker, Christine Fransman, Erwin Birnie, Henk-Jan Aanstoot, Giesje Nefs
Exploring feasible ways of person-reported outcome measurement in routine type 1 diabetes care: a protocol for the Diabeter-PROM study. Front Clin Diabetes Healthc. 2026 Feb 16:7:1729632.
Managing type 1 diabetes (T1D) involves much more than maintaining glucose levels. People with T1D frequently experience psychosocial challenges such as diabetes distress, anxiety, or worries about complications. These factors can affect both quality of life and diabetes outcomes. Clinical guidelines increasingly recommend assessing psychosocial wellbeing as part of routine diabetes care. One way to do this is through person-reported outcome measures (PROMs)—questionnaires that capture patients’ perspectives on their health and wellbeing. However, most existing PROM systems are designed for research and are often too lengthy or insufficiently tailored to routine T1D care. The Diabeter-PROM study was designed to explore a more practical approach to integrating psychosocial assessment into everyday diabetes care.
The Diabeter-PROM study is an observational mixed-methods study aiming to develop a feasible PROM system specifically for routine T1D care. The system focuses on twelve psychosocial domains, including quality of life, mood, anxiety, diabetes-specific worries, eating behaviour, stigma, treatment satisfaction, self-efficacy, self-esteem, social support and resilience. To reduce questionnaire burden, the researchers propose a two-step assessment strategy. Each domain is first screened using a single index question designed to identify whether a potential problem may be present. Only if the response suggests elevated concerns are additional in-depth questions presented. The study evaluates candidate index questions through surveys among people with T1D receiving care at Diabeter clinics. Statistical analyses will determine which questions best identify individuals who may benefit from further psychosocial assessment.
Key POINTS:
- The study aims to develop a practical PROM system tailored to routine T1D care.
- Twelve psychosocial domains relevant to living with T1D are included.
- A two-step approach uses brief index questions followed by targeted in-depth assessment when needed.
- The goal is to balance comprehensive psychosocial screening with minimal burden for patients and healthcare professionals.
If successful, the Diabeter-PROM system could make psychosocial screening easier to implement in routine diabetes care. By identifying relevant issues efficiently, it may help healthcare teams address psychosocial barriers earlier and support more personalized, person-centred diabetes care.
Concluding, the authors state
"Our suggested strategy of index questions signalling the need for in-depth assessment of a certain domain is designed to help prevent question overload while still covering multiple psychosocial domains." -
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