Diabetes-related distress over time and its associations with glucose levels in school-aged children.

Introduction: In a cohort of families of school-age children (8-12.99 years old) with type 1 diabetes, we examined the stability of parent and child diabetes-related distress (DRD) over 6 months and the associations between parent and child DRD and child glycated hemoglobin (HbA1c) over time.

Research design and methods: We recruited families from two large pediatric hospital systems in the USA and used validated measures of parent (Parent Problem Areas in Diabetes-Child, PPAID-C) and child (Problem Areas in Diabetes-Child, PAID-C) DRD and children's HbA1c. We collected data at baseline and 6 months. We calculated minimal clinically important differences in PPAID-C and PAID-C to examine DRD stability and used a linear regression model to examine associations between PPAID-C and PAID-C scores and child HbA1c over time.

Results: We recruited n=132 parent-child dyads (mean child age=10.23±1.5 years; 50% male, 86% non-Hispanic white). 60% of children and 55% of parents reported stable DRD levels, 20% of children and 14% of parents reported increasing DRD levels, and 20% of children and 31% of parents reported decreasing DRD levels from baseline to 6 months. In the regression model, child HbA1c and DRD scores at baseline significantly predicted child HbA1c 6 months later, β=0.013, t(157)=2.32, p=0.02.

Conclusions: Across 6 months, DRD remained stable or increased in 80% of school-aged children and 69% of parents. Only child HbA1c and DRD at baseline predicted higher child HbA1c 6 months later. Our results suggest it may be valuable to screen families of school-age children for DRD routinely and to develop treatments to help them reduce DRD.