693-P: Association of Resilience with Hemoglobin A1c and Mental Health Symptoms in Youth and Young Adults with Diabetes

Introduction & Objective: Studies on resilience in youth and young adults (YYA) with diabetes are scarce. We assessed if resilience was associated with hemoglobin A1c (HbA1c), depressive symptoms, anxiety, and disordered eating behaviors in YYA with type 1 (T1D) and type 2 diabetes (T2D).

Methods: A cross-sectional analysis of the multicenter SEARCH Food Security Cohort study follow-up 2 (2019-2021) was conducted including 762 YYA with T1D and 103 YYA with T2D. Resilience was assessed with the Connor-Davidson Resilience scale; depressive symptoms, anxiety and disordered eating behaviors were assessed with the Center for Epidemiological Studies-Depression scale (clinical cutoff of ≥24 for youth and ≥16 for young adults), the Generalized Anxiety Disorder screener (≥10), and the Diabetes Eating Problem Survey-Revised (≥20). Logistic regression models were performed to examine associations between resilience and the above diabetes-related outcomes, adjusting for sociodemographic and clinical factors.

Results: YYA were on average 25.1 years old, 60.0% female, 71.2% Non-Hispanic White, and classified by tertiles of resilience into low (n=276), intermediate (n=316) and high (n=273) resilience. Among YYA with T1D, compared to those with high resilience, those with low resilience had elevated odds of HbA1c >9% (OR 2.3, 95% CI 1.3-4.1), depressive symptoms (OR 16.5, 95% CI 10.0-27.2), anxiety (OR 7.9, 95% CI 4.8-12.9) and disordered eating behaviors (OR 8.7, 95% CI 4.5-16.6), likewise for those with intermediate resilience. Among YYA with T2D, those with low resilience had higher odds of depressive symptoms (OR 6.5, 95% CI 1.4-29.1) than those with high resilience, but no difference in odds of HbA1c >9%, anxiety or disordered eating behaviors.

Conclusion: Given the potentially cross-cutting impact of resilience on quality of life, mental health, and diabetes self-management in YYA with diabetes, strategies to enhance resilience should be explored.