Blood Glucose Levels and Diabetes Family Conflict in Black Adolescents with Type 1 Diabetes During the COVID-19 Pandemic.

Abstract

The coronavirus 2019 (COVID-19) pandemic escalated family stress and prompted interruptions of regular healthcare visits. Such pandemic-related disruptions may be particularly deleterious among Black youth with chronic health conditions, such as type 1 diabetes. The present study leveraged longitudinal data from a multi-center randomized clinical trial (Clinicaltrials.gov [NCT03168867]) and a follow-up ancillary study focused on effects of COVID-19 to examine blood glucose trajectories and diabetes family conflict among Black adolescents with type 1 diabetes and their caregivers. Throughout the primary and ancillary studies, both adolescents and caregivers reported on their experience of diabetes family conflict across seven study visits. At each of these visits, the adolescent's hemoglobin A1c (HbA1c) was measured as an indicator of their blood glucose levels; further, HbA1c data during the study window was also extracted from the electronic medical record. Results demonstrated that HbA1c among the sample was linearly improving prior to the pandemic, but improvement halted following the onset of COVID-19. Following COVID-19 onset, average HbA1c remained stable, but higher than the recommended level. Higher mean levels of diabetes family conflict across the study were associated with higher HbA1c on average. However, diabetes family conflict did not predict changes in HbA1c trajectories pre- or post-pandemic onset. These findings highlight the potential stagnation of improving health-related outcomes during the COVID-19 pandemic for Black adolescents with type 1 diabetes and the need for further longitudinal work examining the familial and systemic factors contributing to the negative health consequences of the COVID-19 pandemic.