P-204: The essential role of parents in managing type 1 diabetes in very young children: modifiable pathways beyond sociodemographic risk
S M Nozime, A Monzon, S R Patton, J S PierceAbstract
Introduction
Type 1 diabetes (T1D) management for very young children (YC-T1D; <6yrs) is fully dependent on caregivers, and research shows that parental factors impact YC-T1D glycemic outcomes. Data shows that sociodemographic risk is linked to higher glycemic levels; however, the mechanism remains unclear. Parent mental health may represent a modifiable pathway linking social risk to child outcomes.
Objectives
To test whether parent mental health mediates the association between cumulative social risk and HbA1c in YC-T1D.
Methods
Data is from a randomized controlled trial of 143 parents of YC-T1D. Given no intervention effects on outcomes, we combined groups and included randomization status as a covariate. We created a cumulative baseline social risk index using dichotomized indicators (race/ethnicity, parent education, income, insurance). We used the Brief Symptom Inventory (BSI) to assess parent mental health (global distress and depression, anxiety, and somatization subscales) at 6-months. We obtained child HbA1c at 12-months via mailed dried blood spot kits. We conducted mediation analyses in SPSS V27 using PROCESS to examine indirect effects of social risk on HbA1c through parent mental health.
Results
Greater social risk predicted higher global distress, depression, and somatization (p’s<0.05), but not anxiety. Higher global distress and all subscales predicted higher HbA1c (p’s<0.05). Social risk had a significant direct effect on HbA1c (b=0.14, p=0.003) and significant indirect effects through global distress, depression, and somatization (95% CIs excluding zero), but not anxiety.
Conclusions
Parent psychological distress, depression, and somatic symptoms partially explain the association between social risk and glycemic outcomes in YC-T1D. Improving access to evidence-based interventions targeting parent mental health among higher-risk families may improve parent psychosocial and child glycemic outcomes.