Subgroups of pre-adolescents with type 1 diabetes based on profiles of resilience-supporting resources and risk factors.

Objective: There are different profiles of modifiable psychosocial resources and risk factors among adolescents with type 1 diabetes (T1D) that predict long-term differences in diabetes distress, diabetes management behaviors, and glycemic outcomes. Similarly, there may be distinct profiles of resources and risk factors prior to adolescence. Profiles could be used to identify which types of youth might benefit most from targeted intervention before the challenging teen years. The present study sought to identify subgroups of pre-adolescents based on empirically derived profiles of modifiable resilience-enhancing resources and risk factors.

Methods: One-hundred six caregivers and 101 pre-adolescents with T1D ages 9 through 12 years participated in a one-time survey during the COVID-19 pandemic. Latent profile analysis was used to identify subgroups and to assess subgroup relations with covariates and distal outcomes.

Results: Two subgroups provided the best fit to the data. Hypothesized profiles with higher versus lower levels of resilience factors were associated with diabetes outcomes in the expected directions. There were clinically and statistically significant differences between subgroups, such that the Higher Resilience Factor subgroup had lower hemoglobin A1c, engaged in more diabetes management behaviors, and experienced less diabetes distress than the Lower Resilience Factor subgroup.

Conclusions: It is possible to identify subgroups of pre-adolescents based on profiles of modifiable individual- and family-based resources and risk factors. Indicators of collaborative caregiver involvement, diabetes-related family conflict, negative thoughts, diabetes strengths, and diabetes self-efficacy appear especially useful for identifying a more "at-risk" subgroup of pre-adolescents who may benefit most from targeted psychosocial intervention.