UCSF

Type 1 diabetes (T1D) is one of the most common pediatric chronic conditions, where the risk of developing future complications is closely related to the tight surveillance of daily glycemic control. The majority of adolescents with T1D are still unable to meet the target glycemic outcomes. In this cross-sectional study, adolescents with T1D and one caregiver were recruited from telehealth visits at a tertiary, multidisciplinary pediatric diabetes center to complete a self-report survey. Factors included diabetes self-management, diabetes technology use, diabetes distress, parenting stress, and family functioning from the individual and family domains. Age, gender, BMI, insurance type, daily insulin dose, insulin regimen, and A1C were collected by medical chart review. CGM data were collected from device software. Univariate and multivariable regression models were conducted for association with outcomes of interest. The relationship between the diabetes self-management, and individual and family factors with glycemic outcomes are a complex one. Our finding suggests the variables in the family domain, particularly the parent diabetes-related distress, is a crucial, modifiable factor associated with the adolescent’s glycemic outcome. There is also an association between parent diabetes-related distress and the adolescent’s diabetes technology satisfaction. Lastly, there exist a gap between families who adapt to the use diabetes technology when compared to those who do not likely related to socioeconomic status, and future studies are needed to bridge this gap.