Low caregiver state anxiety is associated with worse glycemic control in youth with type 1 diabetes mellitus: a cross-sectional study

Introduction: The impact of caregiver anxiety on management of type 1 diabetes (T1D) is not well understood. This study examined the association between caregiver anxiety, glycemic control, and anxiety symptoms in youth with T1D. Methods: We conducted a cross-sectional study of 200 dyads of youth aged 11-17 years, with T1D duration >1 year and their primary caregivers. Caregiver anxiety was assessed by the State-Trait Anxiety Inventory (STAI), and youth anxiety by the Screen for Child Anxiety Related Emotional Disorders (SCARED). Multiple logistic regression examined associations between STAI quartiles and glycemic control defined as HbA1c ≤ 7.5%. Possible anxiety disorder based on SCARED scores was identified in 60.5% of youth. Higher caregiver STAI-scores correlated with higher youth SCARED-scores. Conclusions: Low caregiver state anxiety was associated with worse glycemic control in youth with T1D, a counterintuitive finding that may reflect differences in caregiver involvement. Anxiety symptoms were highly prevalent among youth in this cohort. These findings highlight the complex interplay between caregiver anxiety, youth anxiety and glycemic control, and support the importance of psychological screening, and family-centered approaches in routine diabetes care.