Association of resilience with hemoglobin A1c among youth and young adults with youth-onset diabetes

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Purpose We assessed whether resilience is associated with hemoglobin A1c (HbA 1c ) in youth and young adults (YYA) with youth-onset type 1 (T1D) and type 2 diabetes (T2D). Methods A cross-sectional analysis of data from the multicenter SEARCH Food Security Cohort study (2019-2022) was conducted including 574 and 82 YYA with youth-onset T1D and T2D, respectively. Resilience, assessed with the 10-item Connor-Davidson Resilience scale, was analyzed in categories determined through tertiles (low ≤25, moderate 26-32, and high ≥33). Multivariable logistic regression models adjusted for sociodemographic and clinical factors, perceived social support, and symptoms of depression, anxiety, and eating problems. Results Regardless of diabetes type, compared to participants with high resilience, those with low resilience had higher odds of HbA1c >9% (OR 1.90, 95% CI 1.06-3.41); the OR was 1.62 (95% CI 0.97-2.70) for those with intermediate resilience. Among YYA with T1D, those with low and intermediate resilience had elevated odds of HbA 1c >9% (OR 1.96, 95% CI 1.02-3.79; OR 2.01, 95% CI 1.13-3.59, respectively) compared to those with high resilience. Conclusions Findings were consistent with the hypothesis that resilience was protective of elevated HbA 1c in YYA with diabetes. Strategies to enhance resilience in these populations might be beneficial.