Objective: Examine the impact of stressful life events on families in the first year after diagnosis of T1D in a young child using a mixed methods design.
Methods: In a prospective study of 5-9 year-olds new to T1D (mean age 7.4±1.3 years, T1D duration 4.7±3.3 months), we measured A1c, changes in family health, marital status, coping, and income every 3 months up to 12 months post-baseline using surveys.
Results: Of 135 families, 40 reported job/income changes (11 promoted, 20 changed job, 7 quit job, 2 lost job), 4 marital changes (2 divorces, 1 separation, 1 spouse death), and 42 health changes (78.6% family member health, 21.4% child). Of those, 4 family members were also diagnosed with T1D and 3 youth were diagnosed with an additional autoimmune disorder in the 12 month follow-up. Income decrease at any time point in first 12 months correlated with health change (r=0.142, p=0.048) and marital status change (r=0.169, p=0.049) at any time point in the first 12 months, while baseline Active Avoidance Coping correlated with future income decrease (r=0.169, p=0.03). There was a cross-sectional association between A1c and income decrease at time point 4, corresponding to ∼1 year post-T1D diagnosis (Table).
Longitudinal HbA1c, incidence of life events, and correlation of income decrease and HbA1c in youth.
| Baseline | 3 Months | 6 Months | 9 Months | 12 Months | |
| Mean HbA1c, % (SD) | 7.66 (±1.3) | 7.72 (±1.2) | 8.(±1.2) | 8.20 (±1.2) | 8.25 (±1.2) |
| Health Change, n (%) | 14 (12.1%) | 11 (10.1%) | 8 (8.3%) | 9 (9.8%) | |
| Marital Status Change, n (%) | 75.7% married | 3 (2.6%) | 0 | 0 | 1 (1.1%) |
| Income Decrease, n (%) | 5 (4.3%) | 9 (8.3%) | 4 (4.2%) | 5 (5.4%) | |
| Cross-sectional Correlation HbA1c To Income Decrease | 0.077 | -0.108 | 0.260** | 0.083 | |
| Sig. (1-tailed) | 0.207 | 0.131 | 0.005 | 0.216 | |
| N | 135 | 116 | 109 | 96 | 92 |
| Baseline | 3 Months | 6 Months | 9 Months | 12 Months | |
| Mean HbA1c, % (SD) | 7.66 (±1.3) | 7.72 (±1.2) | 8.(±1.2) | 8.20 (±1.2) | 8.25 (±1.2) |
| Health Change, n (%) | 14 (12.1%) | 11 (10.1%) | 8 (8.3%) | 9 (9.8%) | |
| Marital Status Change, n (%) | 75.7% married | 3 (2.6%) | 0 | 0 | 1 (1.1%) |
| Income Decrease, n (%) | 5 (4.3%) | 9 (8.3%) | 4 (4.2%) | 5 (5.4%) | |
| Cross-sectional Correlation HbA1c To Income Decrease | 0.077 | -0.108 | 0.260** | 0.083 | |
| Sig. (1-tailed) | 0.207 | 0.131 | 0.005 | 0.216 | |
| N | 135 | 116 | 109 | 96 | 92 |
Conclusions: Families can experience significant concurrent life stressors during the first year of T1D. Future research should explore if these events have a direct effect on T1D management and long-term glycemic control.
K.R. Stanek: None. S. Majidi: None. E.M. Youngkin: None. A. Noser: None. M.A. Clements: Speaker's Bureau; Self; Medtronic. Advisory Panel; Self; Glooko, Inc.. S.R. Patton: None.
