Uncertainty and the Duration of Disease in Adults with Type 1 Diabetes

  • Lisa M. Acuff, MS Harding University
  • Jennfier M. Jabson, PhD University of Tennessee


Objective: The purpose of this study was to investigate the relationship between type 1 diabetes duration and uncertainty. According to the Reconceptualized Uncertainty in Illness Theory, it was hypothesized that longer duration would be associated with less uncertainty.

Research Design and Method: A sample of 379 people with type 1 diabetes recruited from the T1D Exchange completed an online survey. The online survey measured disease duration, uncertainty, and demographic characteristics. Multiple variable linear regression was calculated to test for an association between diabetes duration (in years) and uncertainty in diabetes self-management. Post hoc one-way analysis of variance with Tukey’s HSD test was calculated to investigate uncertainty at five and ten-year disease duration intervals.

Results: With adjustment for age, gender, and education, diabetes duration was negatively associated with uncertainty (b = -0.15, p= .03; 95% CI = -0.28, -0.01). Uncertainty was lowest among the 64 participants with a duration equal to or greater than 40 years (M=63.53, SD=15.04). In Tukey’s HSD post hoc test, the mean difference on the uncertainty scores for 5 to < 10 years diabetes duration (n=38, M=72.66, SD=14.51) and 40 or more years diabetes duration was significant (p = 0.02, 95% CI = 0.81, 17.44).

Conclusions: Individuals with longer disease duration reported less uncertainty related to self-management, and uncertainty varied by duration interval. These findings provide preliminary information about where to place behavioral interventions designed to reduce uncertainty among individuals with type 1 diabetes.

Author Biographies

Lisa M. Acuff, MS, Harding University

 Lisa M. Acuff, MS, is a health sciences librarian at Harding University. She received a Masters degree in Information Sciences from the University of Tennessee, where she also completed an additional year of graduate training in Information Sciences and 2.5 years of graduate training in Public Health. She provides research support for faculty and students in multiple health science programs including communication science disorders, exercise science, nursing, pharmacy, physical therapy, and physician assistant. Her research interests include health literacy, diabetes self-management education, and psychosocial aspects of diabetes.


Jennfier M. Jabson, PhD, University of Tennessee
Jennifer M. Jabson, PhD, MPH, received her doctoral and MPH degrees from Oregon State University with emphasis in women's health and cancer survivorship. After completing her graduate training in public health, she completed an American Cancer Society funded post-doctoral fellowship at Boston University School of Public Health where she specialized in cancer prevention and control and cancer disparities in underserved populations.  Her primary research interests include population health, chronic disease and cancer prevention, and cancer survivorship, including evaluating psychosocial and behavioral factors that influence cancer risk and survivorship among underserved minority groups. Jennifer's scholarly activities include research that explores the role of stress and perceived discrimination in cancer survivorship, health behaviors of racial/ethnic minority cancer survivors, psychosocial factors that relate to chronic disease risk and cancer survivorship among minority groups, and intervention research designed to reduce risk for chronic disease among women in mid-life.
Original Research Articles