Table 1.

Modified DBS items based on content validity feedback.

Item	CVI	Dimension
I’m mentally tired by having to think about my diabetes all the time.	1.00	Exhaustion
Taking care of my diabetes is physically draining.	0.81	Exhaustion
It’s emotionally exhausting to face another day with diabetes.	1.00	Exhaustion
I’m mentally drained because diabetes is a full-time job.	1.00	Exhaustion
I feel physically depleted by my out of range blood glucose numbers.	0.87	Exhaustion
I’m emotionally exhausted by all I am supposed to do to manage my diabetes.	1.00	Exhaustion
I try to think about my diabetes as little as possible.	0.97	Detachment
When it comes to my diabetes management, I do the bare minimum to survive.	0.81	Detachment
I try to convince myself that is OK to ignore my diabetes management.	0.96	Detachment
I know it is important to manage my diabetes, but often I skip it anyway.	0.95	Detachment
I avoid seeking support for my diabetes management.	0.80	Detachment
I try to ignore my diabetes management as much as possible.	0.92	Detachment
I avoid anything that reminds me that I have diabetes.	0.91	Detachment
There is nothing I can do to manage my diabetes, so why bother?	0.89	Loss of control
I struggle to stay on track with my diabetes management.	0.92	Loss of control
I have to force myself to continue managing my diabetes.	0.94	Loss of control
My diabetes is out of my control.	0.96	Loss of control
I try and try but I can’t get a handle on my blood sugar.	0.98	Loss of control