학술논문

Diabetes distress and HbA1c in racially/ethnically and socioeconomically diverse youth with type 1 diabetes.
Document Type
Article
Source
Pediatric Diabetes. Nov2020, Vol. 21 Issue 7, p1362-1369. 8p.
Subject
*TREATMENT of diabetes
*BIOMARKERS
*DIABETES
*PSYCHOLOGICAL distress
*ETHNIC groups
*GLYCOSYLATED hemoglobin
*MULTIVARIATE analysis
*PATIENT education
*QUESTIONNAIRES
*RACE
*SOCIOECONOMIC factors
*CHILDREN
Language
ISSN
1399-543X
Abstract
Background: Diabetes distress, the emotional burden of caring for the chronic demands of diabetes, has not been well described in children and preadolescents with type 1 diabetes (T1D). This gap is particularly evident among youth of lower socioeconomic status (SES) and/or racial/ethnic minorities. Since these groups are more likely to have disparities in health outcomes and healthcare related to their diabetes, factors that could potentially improve glycemic and other diabetes‐related outcomes should be studied closely. Objective: We hypothesized that (a) diabetes distress levels would be elevated in children with markers of lower SES and those of racial/ethnic minorities, and (b) higher HbA1c would be predicted by higher diabetes distress levels, when controlling for race/ethnicity, SES, and clinical covariates. Methods: One hundred and eighty‐seven youth age 9 to 13 with T1D completed age‐appropriate Problem Areas in Diabetes (PAID) questionnaires using a web‐based portal during routine diabetes care visits. Results: PAID scores were significantly elevated in youth who had surrogate markers of lower SES and who were from racial/ethnic minority backgrounds. In multivariate models including race/ethnicity or the SES variables and controlling for clinical covariates, the factor most predictive of higher HbA1c was elevated PAID score. Conclusions: Diabetes distress is elevated in a younger population of children with T1D who are from racial/ethnic minority backgrounds or have markers of lower SES. Interventions that target distress and/or expand the safety net in these populations could potentially improve glycemic outcomes. [ABSTRACT FROM AUTHOR]