550-P: Unique Associations of Depressive Symptoms and Diabetes Distress with Quality of Life (QoL) in Youth with Type 1 Diabetes (T1D)

Youth with T1D often experience emotional distress, which can negatively impact QoL. We sought to understand associations of depressive symptoms and diabetes distress with QoL in youth with T1D. Participants (N=420; 50% male; ages 8-17 years; T1D duration 6.4±3.7 (M±SD) years; A1c 8.3±1.0%; 69% pump treated; 70% having parent with college degree) completed the Pediatric Quality of Life Inventory Generic Core Scales (PedsQL)and measures of depressive symptoms (Center for Epidemiologic Studies Depression Scale [CESD]) and diabetes distress (Problem Areas in Diabetes-Pediatric version [PAID-Peds]). Multivariable linear modeling determined independent associations of depressive symptoms and diabetes distress with total, physical, and psychosocial QoL, adjusting for sex, age, T1D duration, A1c, pump therapy, insulin dose, and parent education. Total PedsQL score was 85±13, (physical subscale 89±12, psychosocial subscale 82±15); CESD score was 9±9; PAID-Peds score was 37±24. CESD and PAID-Peds were both correlated with A1c (CESD: p=.01, PAID-Peds: p<.0001); QoL scales were not correlated with A1c. CESD and PAID-Peds were correlated with total, physical and psychosocial QoL (all p<.0001). In multivariable analyses, more depressive symptoms were associated with poorer total (∆R²=.52, p<.0001), physical (∆R²=.35, p<.0001), and psychosocial (∆R²=.51, p<.0001) QoL, adjusting for diabetes distress and sociodemographic/diabetes factors. More diabetes distress was associated with poorer total (∆R²=.05, p<.0001) and psychosocial (∆R²=.06, p< .0001) QoL, adjusting for depressive symptoms and sociodemographic/diabetes factors; more diabetes distress marginally contributed to poorer physical QoL (∆R²=.01, p=.002). Findings suggest unique, negative associations of both depressive symptoms and diabetes distress with QoL. Targeting both depressive symptoms and diabetes distress may help improve QoL in youth with T1D.