Relationships Among Stress, Diabetes Distress, and Biomarkers in Children with Type 1 Diabetes Mellitus from Diverse Income and Racial Backgrounds.
Sara L Davis, Sarah S Jaser, Nataliya Ivankova and 1 others
PMID 39387754WHAT IT FOUND
Children with type 1 diabetes who reported more stress had higher HbA1c levels.
Parents did not report the same stress. HbA1c was higher in Black children, and White children used more diabetes technology.
Key findings
01Children's own reports of perceived stress were associated with higher HbA1c levels, while parent reports were not.
02Black children had higher HbA1c levels than White children, with a large effect size.
03White children were more likely to use insulin pumps (50%) and continuous glucose monitors (80%) than Black children (21.4% and 42.8%).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The sample was small (34 children) and recruited by convenience sampling, so it cannot show cause and effect. The race and income groups were uneven, including only 2 high-income Black children. Cortisol data were missing for all children who did not return saliva samples, and those children were all low-income Black children with higher HbA1c levels. The study used a cross-sectional design, so stress, cortisol, inflammation, and HbA1c could not be ordered in time. Mediation analyses were exploratory and based on a small sample. The stress tools were validated for ages 8 to 12 but may not capture newer stressors such as social media.
Declared interests
The article is listed as supported by NIH extramural research funding, and all authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that stress reduction, cortisol changes, or IL-8 cause worse diabetes control. This was a small cross-sectional study, and mediation analyses were exploratory; it shows associations only.