Diabetes distress and HbA1c in racially/ethnically and socioeconomically diverse youth with type 1 diabetes

Kelly Fegan-Bohm, Charles G. Minard, Barbara J. Anderson, Ashley M. Butler, Courtney Titus, Jill Weissberg-Benchell, Marisa E. Hilliard*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Diabetes distress, the emotional burden of caring for the chronic demands of diabetes, has not been well described in children and preadolescents with type 1 diabetes (T1D). This gap is particularly evident among youth of lower socioeconomic status (SES) and/or racial/ethnic minorities. Since these groups are more likely to have disparities in health outcomes and healthcare related to their diabetes, factors that could potentially improve glycemic and other diabetes-related outcomes should be studied closely. Objective: We hypothesized that (a) diabetes distress levels would be elevated in children with markers of lower SES and those of racial/ethnic minorities, and (b) higher HbA1c would be predicted by higher diabetes distress levels, when controlling for race/ethnicity, SES, and clinical covariates. Methods: One hundred and eighty-seven youth age 9 to 13 with T1D completed age-appropriate Problem Areas in Diabetes (PAID) questionnaires using a web-based portal during routine diabetes care visits. Results: PAID scores were significantly elevated in youth who had surrogate markers of lower SES and who were from racial/ethnic minority backgrounds. In multivariate models including race/ethnicity or the SES variables and controlling for clinical covariates, the factor most predictive of higher HbA1c was elevated PAID score. Conclusions: Diabetes distress is elevated in a younger population of children with T1D who are from racial/ethnic minority backgrounds or have markers of lower SES. Interventions that target distress and/or expand the safety net in these populations could potentially improve glycemic outcomes.

Original languageEnglish (US)
Pages (from-to)1362-1369
Number of pages8
JournalPediatric Diabetes
Issue number7
StatePublished - Nov 1 2020


  • adolescent
  • child
  • diabetes mellitus, type 1
  • minority
  • psychological factors
  • socioeconomic status

ASJC Scopus subject areas

  • Internal Medicine
  • Pediatrics, Perinatology, and Child Health
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Diabetes distress and HbA1c in racially/ethnically and socioeconomically diverse youth with type 1 diabetes'. Together they form a unique fingerprint.

Cite this