Higher baseline diabetes distress in youth with elevated A1C predicted higher illness rejection at 6 months (β=0.2, p=0.015) and 12 months (β=0.2, p=0.03), and lower illness acceptance at 12 months.
Cohort (n=54)
Does baseline diabetes distress predict illness identity acceptance and rejection in youth with high-risk diabetes?
In youth with high-risk diabetes, baseline diabetes distress predicts higher illness rejection and lower illness acceptance over 12 months, suggesting early interventions targeting distress may improve health outcomes.
Effect estimate: β=0.2
p-value: p=0.015
Introduction and Objective: Illness identity is linked to diabetes management, glycemia, and psychosocial functioning in adolescents and young adults. High illness acceptance and low illness rejection are associated with optimal health outcomes. Adolescents at highest risk of poor outcomes may be especially challenged to integrate diabetes into identity. This study aims to understand the link between diabetes distress and illness identity in a higher risk youth sample. Methods: This longitudinal study enrolled youth living with diabetes with A1c≥10% and/or repeated diabetes-related hospital or emergency department admissions. Youth and their primary caregivers completed monthly surveys of illness identity, diabetes distress, and social support over one year. Multiple regression evaluated predictors of illness identity acceptance and rejection at 6- and 12-months post-baseline, covarying for baseline acceptance and rejection. Results: The sample (N=54, Mage=15. 0 SD: 1. 6) was 85% BIPOC youth; 52% female; and 67% 50K annual family income. Diabetes type was 70% T1D, 22% T2D, 8% other diabetes. Higher baseline diabetes distress in youth predicted higher illness rejection at 6- (β=0. 2, p=. 015) and 12-months (β=0. 2, p=. 03), and lower illness acceptance (β=−0. 1, p=. 01) at 12 months. Neither parent diabetes distress nor youth/parent social support predicted illness identity. Conclusion: This study bolsters the literature by exploring important relationships with a unique sample of youth from historically marginalized groups experiencing health inequities. Results suggest that baseline diabetes distress is associated earlier and more consistently with illness rejection, whereas associations with illness acceptance are observed only at later follow-up. Early interventions targeting diabetes distress in youth experiencing high social risk with many competing challenges may help to mitigate rejection and facilitate diabetes acceptance to improve health outcomes. Disclosure C. Nam: None. J. Shapiro: Research Support; Current; American Diabetes Association, Leona M. and Harry B. Helmsley Charitable Trust, Eli Lilly and Company. J. Ellis: None. P. Commissariat: None. D. V. Wagner: None. J. Weissberg-Benchell: Consultant; Ended; Sanofi. K. Torres: None. M. A. Harris: None. A. C. Swamy: Speaker's Bureau; Current; Dexcom, Inc. , Sanofi, Insulet Corporation. J. C. Wong: Research Support; Ended; Abbott Diabetes. A. T. Vesco: None. Funding American Diabetes Association (11-21-ICTSHD-49)
Nam et al. (Fri,) conducted a cohort in Diabetes (n=54). Baseline diabetes distress was evaluated on Illness rejection at 6 months (β=0.2, p=0.015). Higher baseline diabetes distress in youth with elevated A1C predicted higher illness rejection at 6 months (β=0.2, p=0.015) and 12 months (β=0.2, p=0.03), and lower illness acceptance at 12 months.
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