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Background Many adolescents with type 1 diabetes experience diabetes distress which is associated with suboptimal glycemic and psychosocial outcomes. The ways in which adolescents respond to diabetes distress may serve as a risk or protective factor for these outcomes, but few studies have examined the coping strategies adolescents use to manage diabetes distress. Purpose To examine the association of coping strategies with glycemic and psychosocial outcomes among adolescents experiencing diabetes distress. Methods Participants included 198 adolescents with elevated diabetes distress who completed baseline data for a randomized controlled trial (M age = 15.3 ± 1.4, 58% female, 58% non-Hispanic White, M A1c = 9.1 ± 2.1%). Adolescents reported on their use of coping strategies related to diabetes stressors, including primary control engagement coping (e.g. problem-solving), secondary control engagement coping (e.g. positive thinking), and disengagement coping (e.g. avoidance). Adolescents also completed measures of diabetes distress, quality of life, and resilience. HbA1c data were extracted from electronic medical records and at-home kits. Results Higher use of primary control engagement coping was associated with better glycemic and psychosocial outcomes. Secondary control engagement coping was associated with better psychosocial outcomes but not glycemic outcomes. Greater use of disengagement coping strategies was associated with poorer glycemic and psychosocial outcomes. All associations were significant after adjusting for adolescent sex, age, race/ethnicity, and continuous glucose monitor use. Conclusions These results build on prior findings by including a more diverse sample of adolescents and highlight the value of promoting engagement coping strategies and discouraging the use of disengagement coping strategies among adolescents experiencing diabetes distress. Clinical Trial information NCT03845465. [ABSTRACT FROM AUTHOR]

Objective: Eighteen percent of new diagnoses of type 1 diabetes (T1D) occur in children ages 9 and younger, and the burden of diabetes management in young children predominantly falls on parents. Despite the significant amount of information parents must learn and implement quickly after diagnosis, little research has examined diabetes self‐efficacy in parents of young children soon after diagnosis in a longitudinal manner. The current study examined changes in parent diabetes self‐efficacy over time, and parent depressive symptoms and stress soon after child T1D diagnosis as predictors of parent diabetes self‐efficacy at 12‐ and 18‐months post‐diagnosis. Research design and methods: One hundred fifty‐seven primary caregivers (91.7% female, 62.2% White, Non‐Hispanic) of young children (Mage = 4.47 ± 1.65 years, 54.8% female, 60% White, Non‐Hispanic) were recruited within 2 months of their child's T1D diagnosis from two pediatric hospitals in the United States as part of a randomized clinical trial. Parents self‐reported on their diabetes self‐efficacy, depressive symptoms, and stress and at baseline (Mdays since diagnosis = 29) and on parent diabetes self‐efficacy again 12‐ and 18‐months post‐diagnosis. Results: Parent diabetes self‐efficacy significantly improved from baseline to 12‐months and 18‐months post‐diagnosis (p < 0.05). Parents exhibiting clinically elevated levels of depressive symptoms and stress at baseline had significantly lower parent diabetes self‐efficacy 12‐ and 18‐months post‐diagnosis compared to parents with normal levels of depressive symptoms and stress. Conclusions: Brief interventions for parents with clinically elevated depressive symptoms and stress soon after their child's diagnosis may improve parents' diabetes self‐efficacy and ultimately support the management of their child's diabetes. [ABSTRACT FROM AUTHOR]

Low-calorie sweeteners (LCSs) provide sweetness without sugar or calories and are used to replace added sugars by many children with type 1 diabetes (T1D). However, the role of LCSs in diabetes management and cardiometabolic health is unclear. The Diabetes Research in Kids Study (DRINK-T1D) aims to investigate effects of LCS restriction on glycemic variability, visceral adiposity, lipid profiles, and systemic inflammation among children 6–12 years old with T1D. Children with T1D, who report habitual consumption of foods and beverages containing LCSs, are recruited from the Washington Nationals Diabetes Care Complex (DCC) at Children's National Hospital (CNH) in Washington, DC. Following a phone screening and two-week run-in period involving continuation of usual LCS intake, children are randomized to 12 weeks of LCS restriction (replacement of diet beverages with still or sparkling water and avoidance of other sources of LCSs) or continued usual LCS intake (control). The primary outcome is the difference in change in glycemic variability in the LCS restriction group versus the control group. Change in glycemic variability will be assessed as the difference in daily average time-in-range (TIR), measured using continuous glucose monitoring (CGM) during two weeks at the end of the 12-week intervention, compared with during the two-week run-in period prior to randomization. Participants also complete a variety of anthropometric, metabolic, dietary, and behavioral assessments throughout the 14-week study. DRINK-T1D is an innovative, randomized controlled trial, evaluating effects of LCS restriction on glycemic variability and cardiometabolic health in children with T1D. Findings of DRINK-T1D will support or challenge the common practice of recommending LCS use in this patient population and will have clinically relevant implications for pediatric T1D management. ClinicalTrials.gov Identifier NCT04385888. [ABSTRACT FROM AUTHOR]