(PS14-54) The Role of Diabetes-related Post-traumatic Stress Symptoms and Resilience in Diabetes Management Among Adolescents and Young Adults with Type 1 Diabetes

Objectives: This research probes the interrelations between Post-Traumatic Stress Symptoms (PTSS), emanating from diabetes-related events, and the management of Type 1 Diabetes (T1D) in Adolescents and Young Adults (AYA). It further examines the contributions of depression, anxiety, and particularly, resilience to self-care practices, glycemic control, and diabetes-related distress.

Methods: In an urban-based pediatric diabetes unit in the United States, 50 AYA with T1D aged 14–25 participated in this exploratory study. Through validated self-reported assessments and review of medical records, data on HbA1c levels, diabetes self-care behaviors, mental health symptoms, and resilience were collected.  This study employed Pearson’s correlation and Point-Biserial correlation analyses to explore the strength and direction of associations between variables. Subsequently, this study utilized hierarchical multiple regression, followed by ANOVA for model comparisons, and logistic regression analyses to discern the interplay among the variables.

Results: Of the participants, 28% showed clinically relevant levels of PTSS. PTSS was significantly correlated with depression (r = 0.478, p = 0.005), anxiety (r = 0.455, p < 0.001), and resilience (r = -0.340, p = 0.016). Resilience was notably associated with better self-care behaviors and less diabetes-related distress. Although PTSS showed a trend towards a negative impact on self-care (r = -0.269, p = 0.059), it did not significantly correlate with HbA1c levels. Resilience had a positive correlations with self-care and an inverse relationship with distress, albeit without significantly moderating the effect of PTSS on diabetes management outcomes. Logistic regression analysis underscored the role of resilience, revealing a trend towards significance in lowering the odds of experiencing diabetes distress.

Discussion: This investigation illuminates the significant yet complex influence of PTSS, stemming from diabetes-related events, on diabetes management in AYA with T1D. The findings reveal the critical role of resilience in navigating the challenges of diabetes care. While resilience did not statistically moderate the relationship between PTSS and diabetes management outcomes, its association with better self-care and reduced distress merits attention.

Conclusion: Our study stands as one of the pioneering efforts to examine how PTSS, stemming from diabetes-related events, interplays with diverse factors. Our findings advocate for the incorporation of trauma-informed care (TIC) principles into diabetes management protocols for AYA with T1D. Recognizing the impact of diabetes-related PTSS and the protective role of resilience offers a holistic approach to care that addresses both the physiological and psychological needs of this population. Future interventions should aim to enhance resilience among AYA with T1D and integrate TIC practices to support individuals experiencing diabetes-related traumatic stress, fostering improved diabetes outcomes and psychological well-being.