Data for Insulin Non-Adherence in Type 1 Diabetes.xlsx

Design<br>A cross-sectional, web-based survey design was employed, consisting of validated self-report measures designed to capture demographic information, insulin use, diabetes-related distress, disordered eating, and body shape perception.<b>Inclusion/Exclusion criteria.</b> Participants were eligible to participate if they self-described as being aged 18 or over, with a diagnosis of Type 1 diabetes and on a prescribed insulin regimen. They were required to be at least one-year post-diagnosis, as people who have been prescribed insulin for less than one year may not have settled into a routine with insulin management and may mismanage their insulin unintentionally. Additionally, participants were required to reside within the UK, as this removed a potential confound of cost or resources as a barrier to accessing insulin. People with a diagnosis of type 2 diabetes were excluded from the study, as the pathophysiology and treatment of the two illnesses are quite different. For example, as those with type 2 diabetes still produce some degree of insulin naturally, non-adherence to an insulin regimen is likely to have less of an immediate impact than for those with type 1 diabetes, who produce no insulin naturally (Peyrot <i>et al</i>., 2010). Potential participants were provided with a link to the study which provided detailed information about the study, details of informed consent and their right to withdraw. When the survey was completed, or participants chose to exit, a debrief page was presented with signposts towards various supports and resources. Participants were offered the opportunity to receive a brief summary of findings from the study and given the chance to win a £25 Amazon gift voucher, both of which required an email address to be supplied through separate surveys, so as to protect the confidentiality of responses. Ethical approval for this study was granted by the chair of the relevant Ethics Committee.Statistical AnalysisPrior to beginning the study, an estimate of the minimum number of participants required was calculated using statistical power tables (Clark-Carter, 2010) and G*Power version 3.1. Based on previous research (Ames, 2017), a medium effect size (.5) was used to calculate sample sizes with a power of .8 (Clark-Carter, 2010), which generated a necessary sample size of 208. All analyses were adequately powered.Data were analysed using IBM SPSS Statistics for Mac version 25. Measures<b>Demographic Information</b>. This section collected basic demographic information, including age; gender; country of residence; and current or historical diagnosis of an eating disorder. The data were screened to ensure participants met the inclusion criteria.<b>Insulin Measure</b>. A 16-item questionnaire has been designed to assess rates and reasons for insulin non-adherence (Ames, 2017). <b>Eating Disorder Psychopathology</b>. The Eating Disorder Examination-Questionnaire (EDE-Q) assesses eating disorder psychopathology, and data from this measure was key to informing the primary research questions. It was designed as a self-report version of the interview-based Eating Disorders Examination (EDE; 32), which is considered to be the gold standard measure (Fairburn, Wilson, &amp; Schleimer, 1993). The EDE-Q assesses four subscales: Restraint, Eating Concern, Shape Concern, and Weight Concern. It was found to be an adequate alternative to the EDE (Fairburn &amp; Beglin, 1994). <b>Body Shape Questionnaire (BSQ)</b>. The Body Shape Questionnaire is a 34-item self-report measure, designed to assess concerns regarding body shape and the phenomenological experience of “feeling fat” (Cooper, Taylor, Cooper, &amp; Fairbum, 1987). The BSQ targets body image as a central feature of both AN and BN and thus is a useful supplementary measure of eating disorder psychopathology. <b>Diabetes Distress</b>. The Diabetes Distress Scale (Polonsky <i>et al</i>., 2005) is a 17-item scale designed to measure diabetes-related emotional distress via four domains: emotional burden, physician distress, interpersonal distress and regimenn distress. This measure was included on the basis of results from Ames (Ames, 2017), which identified diabetes-related emotional distress as a key reason for insulin non-adherence in type 1 diabetes. Inclusion in this study allowed for further investigation of its role.