Relationships Among Stress, Diabetes Distress, and Biomarkers in Children with Type 1 Diabetes Mellitus from Diverse Income and Racial Backgrounds

•85% of children did not meet recommended glycemic targets.•Black children had significantly higher glycemic levels.•HbA1c was significantly associated with child reports of perceived stress.•Cortisol and IL-8 may mediate the relationship between perceived stress and HbA1c. The purpose of this quant...

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Published in:Journal of pediatric health care 2025-01, Vol.39 (1), p.5-13
Main Authors: Davis, Sara L., Jaser, Sarah S., Ivankova, Nataliya, Rice, Marti
Format: Article
Language:English
Subjects:
biomarkers
Biomarkers - blood
Black or African American - psychology
Blood Glucose - analysis
Blood Glucose - metabolism
Child
Cross-Sectional Studies
Diabetes Mellitus, Type 1 - blood
Diabetes Mellitus, Type 1 - ethnology
Diabetes Mellitus, Type 1 - psychology
Female
Glycated Hemoglobin - analysis
Glycated Hemoglobin - metabolism
glycemic control
Humans
Hydrocortisone - analysis
Hydrocortisone - blood
Hydrocortisone - metabolism
Male
Saliva - chemistry
Saliva - metabolism
stress
Stress, Psychological
underrepresented populations
White
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Summary:•85% of children did not meet recommended glycemic targets.•Black children had significantly higher glycemic levels.•HbA1c was significantly associated with child reports of perceived stress.•Cortisol and IL-8 may mediate the relationship between perceived stress and HbA1c. The purpose of this quantitative study was to consider factors that may negatively impact glycemic levels in Black and White children 8–12 years old with a diagnosis of type 1 diabetes mellitus. Perceived stress, diabetes distress, morning and afternoon salivary cortisol, inflammatory biomarkers, and hemoglobin A1c (HbA1c) were measured in this quantitative, cross-sectional phase of a larger, mixed methods study. Thirty-four children and their parents completed self-report surveys, and children provided blood and salivary samples, to examine effect sizes of relationships among variables of interest. Most children did not meet ADA recommendations for HbA1c. HbA1c was higher in Black children. Medium-to-large effects were noted between perceived stress and HbA1c. Cortisol and IL-8 may mediate the relationship between perceived stress and HbA1c in children. Understanding causes of elevated glycemic levels in children, especially from low-income and underrepresented populations, may help tailor diabetes management interventions to improve health outcomes.
ISSN:0891-5245
1532-656X
1532-656X
DOI:10.1016/j.pedhc.2024.08.012