PRIORITY sub study

Background and aims

Identification of patients who will benefit most of medical treatment is a core task for the therapist. Screening for risk markers including HbA1c, blood pressure and lipid profile are well-known parameters for this purpose. However little is known about how risk-assessment affects the patient and interacts with psychosocial aspects. 

Psychosocial problems are highly prevalent in people with diabetes. This includes mental health disorders, general psychological aspects such as stress and psychological aspects specifically related to living with diabetes.

Diabetes distress reflects an emotional response to diabetes and refers to worries, concerns and fears experienced by people with diabetes. It is defined by the context of diabetes and is linked to e.g. specific stressors such as worrying about complications and treatment regimen. Therefore it is likely that screening for kidney disease and the introduction of the results of screening can increase diabetes distress. 

The aim of this study is to investigate to what extent diabetes distress is affected by individualized information about future risk of kidney disease development including: 

  • To explore differences in patients’ level of diabetes distress before kidney disease screening and after 
  • To explore how the level of diabetes distress changes over time in patients at high risk of kidney disease attending additional consultations and treatment compared to patients at low risk of kidney disease attending regular treatment 
  • To explore differences in diabetes distress changes dependent on initial level of diabetes distress (comparing patients with high vs. low diabetes distress before the screening) 
  • To assess the influence of social support, diabetes empowerment and sense of coherence on the differences in diabetes distress before and after screening. 

Design and Methods

At the time of the kidney disease screening visit for the PRIORITY project the potential participants will be asked to participate in this project. 

The study consists of the following assessments: 

  • Diabetes Distress (DDS17), Sense of Coherence (SOC), Diabetes Empowerment (DES-SF) and social support prior to the urine test. 
  • DDS17, DES-SF and social support after provision of the screening results (approximately 6-8 weeks after screening). 
  • DDS17, SOC, DES-SF and social support at follow-up visits after inclusion in the high or low risk study arm. 

Target groups

People with type 2 diabetes with normoalbuminuria.
Only participants fulfilling inclusion and exclusion criteria for the clinical PRIORITY trial will enter this sub-study. (indsæt link til web beskrivelse af PRIORITY).

Expected outcomes

The inclusion of psychosocial assessment in the PRIORITY study can provide important information on patients’ emotional response to screening for e.g. kidney disease and thereby inform clinical decision making and future recommendations for support in relation to screening procedures. In addition, it may expand the range of intervention options to address diabetes-related life stressors that can influence diabetes management.


The study is a collaboration between two research groups at Steno Diabetes Center, Complications Research and Health Promotion Research. 
Complications Research, Peter Rossing, Morten Lindhardt and Marie Frimodt-Møller. 
Health Promotion Research, Diabetes Management Research, Lene Eide Joensen and Ingrid Willaing.

Responsible editor