Objective: Adolescents are often expected to take on more autonomy in their T1D management, which can increase diabetes distress. Elevated distress has been linked to suboptimal glycemic outcomes. Characterizing the aspects of diabetes distress that teens report as most difficult may help care teams address the most relevant psychosocial concerns during this challenging developmental stage.

Methods: We analyzed baseline data from two behavioral trials, totaling 135 adolescents (age 12-17) with T1D (M age=15.1±1.6, 57% female, 59% non-Hispanic White, M HbA1c=8.7±1.9). Youth completed the Problem Areas in Diabetes Teen scale, a measure of diabetes distress where teens rate how much each of 26 items is a problem for them (6-point scale, 5-6 represent a “serious problem”). We extracted HbA1c from the electronic medical record.

Results: The Table presents the frequency with which teens rated each item as “serious problem” and significant correlations with HbA1c.

Conclusion: A wide range of issues (20 of 26 items) were endorsed by ≥10% of teens as very distressing. At least 20% identified social issues and concerns about possible complications as problems causing serious distress. Items significantly linked to HbA1c were not necessarily those that teens found most distressing. Addressing teens’ most pressing concerns may help them feel understood, reduce self-management barriers, and ultimately improve quality of life and health.


V.T. Cao: None. S.S. Eshtehardi: None. B. Anderson: None. M.E. Hilliard: None.


National Institutes of Health (1R21DK107951); Texas Children’s Hospital; Caroline Weiss Law Fund for Research in Molecular Medicine

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