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. 2025 Jan-Feb;39(1):5-13.
doi: 10.1016/j.pedhc.2024.08.012. Epub 2024 Oct 10.

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

Sara L Davis, Sarah S Jaser, Nataliya Ivankova, Marti Rice

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

Sara L Davis et al. J Pediatr Health Care. 2025 Jan-Feb.

Abstract

Introduction: 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.

Method: 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.

Results: 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.

Discussion: 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.

Keywords: biomarkers; glycemic control; stress; underrepresented populations.

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Conflict of interest statement

CONFLICTS OF INTEREST All authors declare no conflicts of interest.

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