Clinical and Demographic Characteristics Associated with Type 1 Diabetes Distress in Latin American Children

To determine the degree of diabetes-specific distress in children with type 1 diabetes mellitus (T1DM) and its association with demographic characteristics, family and educational situation indicators, glycemic control, complications, and disease duration. A cross-sectional study (Jan-Mar 2025) in Argentina and Chile included 143 T1DM patients (8-17 years, ≥1-year duration). Diabetes distress was measured using the Problem Areas in Diabetes (PAID) questionnaire (0-80; high distress ≥40). One hundred forty-three children (53.8%; 77 females), median age 13.4 years (IQR 11.5-15.8 years), T1DM duration 4.4 y (IQR 3.3-6.6 years), hemoglobin A1c (HbA1c) 8.5%, 69.8 mmol/mol (IQR 7.4%-9.4%), were included. The median PAID score was 25 (IQR 15-42), with 28% (95% CI: 20.6-35.3) experiencing high distress (PAID ≥ 40). HbA1c was higher in children with high distress 9.00% (IQR: 8.1%-10.4%) than in moderate 8.5% (IQR: 7.5%-9.7%) or low distress 7.8% (IQR: 7.0%-8.9%). There was a higher prevalence of children living with only one parent among those with high or moderate distress (33.3%, 95% CI: 24%-34%) compared to those with low distress (9.8%, 95% CI: 2%-18%). Multiple logistic regression analysis revealed that higher HbA1c values were significantly associated with being in the high distress group (OR = 1.48; 95% CI: 1.12-1.96 per % point HbA1c), adjusted for confounding variables. Diabetes distress was linked to higher HbA1c in Latin American children with T1DM. This suggests that addressing diabetes distress may contribute to improved glycemic control.