Parental diabetes distress is a stronger predictor of child HbA1c than diabetes device use in school-age children with type 1 diabetes.
Parental diabetes distress is a stronger predictor of child HbA1c than diabetes device use in school-age children with type 1 diabetes.
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DOI：
10.1136/bmjdrc-2023-003607
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发表时间：
2023-09
影响因子：
4.1
通讯作者：
Clements, Mark A.
中科院分区：
文献类型：
--
作者：
Patton, Susana R.;Kahhan, Nicole;Pierce, Jessica S.;Benson, Matthew;Fox, Larry A.;Clements, Mark A.
糖尿病痛苦（DD）描述了与1型糖尿病（T1 D）一起生活和照顾1型糖尿病患者的无情情感和行为挑战。我们在157个学龄儿童家庭中调查了父母报告和儿童报告的DD、T1 D器械使用和儿童糖化血红蛋白（HbA 1c）之间的相关性。父母完成了糖尿病-儿童（PPAID-C）中的父母问题领域，儿童完成了糖尿病-儿童（PAID-C）中的问题领域，以评估DD水平。父母还填写了一份人口统计表，其中他们报告了当前胰岛素泵或动态血糖监测仪（CGM）的使用情况（即，用户/非用户）。我们使用有效的家庭试剂盒和中心实验室测量儿童HbA 1c。我们使用相关性和线性回归进行分析。儿童中49%为男孩，77.1%为非西班牙裔白色（儿童年龄（平均值±SD）=10.2±1.5岁，T1 D持续时间=3.8±2.4年，HbA 1c =7.96±1.62%）。大多数父母自认为是母亲（89%）和已婚（78%）。父母的平均PPAID-C评分为51.83±16.79（范围：16-96），儿童的平均PAID-C评分为31.59±12.39（范围：11-66）。较高的儿童HbA 1c与非胰岛素泵使用者（r=-0.16，p<0.05）、较高的PPAID-C评分（r=0.36，p<0.001）和较高的PAID-C评分（r=0.24，p<0.001）相关，但儿童HbA 1c与CGM使用之间没有相关性。基于人口统计学变量、胰岛素泵使用以及父母报告和儿童报告的DD预测儿童HbA 1c的回归模型表明，父母的PPAID-C评分是儿童HbA 1c的最强预测因子。我们的分析表明，父母DD是儿童HbA 1c的强预测因子，也是降低儿童HbA 1c的另一个可修改的治疗目标。
Diabetes distress (DD) describes the unrelenting emotional and behavioral challenges of living with, and caring for someone living with, type 1 diabetes (T1D). We investigated associations between parent-reported and child-reported DD, T1D device use, and child glycated hemoglobin (HbA1c) in 157 families of school-age children. Parents completed the Parent Problem Areas in Diabetes-Child (PPAID-C) and children completed the Problem Areas in Diabetes-Child (PAID-C) to assess for DD levels. Parents also completed a demographic form where they reported current insulin pump or continuous glucose monitor (CGM) use (ie, user/non-user). We measured child HbA1c using a valid home kit and central laboratory. We used correlations and linear regression for our analyses. Children were 49% boys and 77.1% non-Hispanic white (child age (mean±SD)=10.2±1.5 years, T1D duration=3.8±2.4 years, HbA1c=7.96±1.62%). Most parents self-identified as mothers (89%) and as married (78%). Parents’ mean PPAID-C score was 51.83±16.79 (range: 16–96) and children’s mean PAID-C score was 31.59±12.39 (range: 11–66). Higher child HbA1c correlated with non-pump users (r=−0.16, p<0.05), higher PPAID-C scores (r=0.36, p<0.001) and higher PAID-C scores (r=0.24, p<0.001), but there was no association between child HbA1c and CGM use. A regression model predicting child HbA1c based on demographic variables, pump use, and parent-reported and child-reported DD suggested parents’ PPAID-C score was the strongest predictor of child HbA1c. Our analyses suggest parent DD is a strong predictor of child HbA1c and is another modifiable treatment target for lowering child HbA1c.
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影响因子：
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