Introduction: New onset of T1D is stressful for patients and families and may be particularly so when the child is acutely ill at diagnosis. To characterize family experiences at new onset in young children, we examined associations among diabetic ketoacidosis (DKA) status, length of hospitalization, family demographics, and parent psychological outcomes. We hypothesized that parents of children in DKA or with longer hospitalizations would have more depressive symptoms, perceived stress, and anxiety.
Methods: We enrolled 157 parents (90% female, M age=34.9y ± 7, 61% White, 75% married) of children ages 1-6 years (M age=4.5) newly diagnosed with T1D. Parents self-reported on depressive symptoms (Center for Epidemiological Studies Depression Scale; CESD), anxiety (Patient Reported Outcomes Measurement Information Systems; PROMIS), and stress (Perceived Stress Scale; PSS), as well as family demographics and subjective social status at baseline (M days post diagnosis=27.4 ± 15) of a behavioral RCT. DKA status and length of hospitalization at diagnosis were obtained via medical chart review.
Results: Over 1/3 (37%, n=57) of the sample presented in DKA and 22.9% were hospitalized >2 nights (M length = 1.92 nights), however neither were associated with parental psychological outcomes. Non-white parents, younger children, and lower subjective social status were associated with DKA at diagnosis (all p<0.05).
Conclusions: Children’s illness severity at T1D diagnosis was not associated with parents’ self-reported stress, anxiety, or depressive symptoms. However, demographic differences of children in DKA at diagnosis suggest health disparities exist. Given that DKA is life-threatening and has neurocognitive effects, efforts to increase awareness and education about T1D onset symptoms in communities, schools, and pediatricians is warranted.
L. Clary: None. M. Sinisterra: None. W. Levy: None. B.E. Marks: None. M.E. Hilliard: None. R. Streisand: None. C. Tully: None.
National Institute of Diabetes and Digestive and Kidney Diseases (R01DK102561)