Diabetes distress in Indian children with type 1 diabetes mellitus and their mothers

Background: Children and their mothers, who are usually the primary caregivers, are likely to be distressed due to type 1 diabetes (T1DM). Objectives: (1) To assess diabetes-specific distress (DD) perceived by children and adolescents with T1DM and their mothers and association of distress between children and mothers. (2) To study the association of diabetes distress with glycemic control and disease duration. Subjects: Children and adolescents with T1DM over eight years and their mothers. Methods: Clinical data were recorded. DD was assessed by Problem Associated in Diabetes-Pediatric (PAID-Peds) (range 0-80) and Problem Associated in Diabetes-Parents Revised (PAID-PR) (range 0-72) questionnaires (higher scores indicate higher distress); administered to children and mothers, respectively. Sub-dimensions in questionnaires included diabetes-related emotional problems, and treatment-, food-, and social support-related problems. Correlation analysis (Spearman's) was performed, and a paired t-test was used to compare PAID-Peds and PAID-PR (SPSS 25). Results: Mean PAID-Peds and PAID-PR scores in 67 children and mothers were 24.4 +/- 18.1 and 31.9 +/- 21.5, respectively (p=0.009), and a significant correlation was noted between their scores (R=0.45, p=0.001). PAID-Peds score was positively associated with HbAlc (R=0.25, p=0.04). Diabetes-related emotional problems of mothers and children (R=0.38, p=0.003), treatment problems (R=0.5, p=0.001), and food problems (R=0.24, p=0.05) correlated positively. Subdimension scores were significantly different in children and mothers except in the social support domain. Conclusion: DD was higher in mothers than children; higher distress in children was associated with poor metabolic control. Evaluation of DD needs to be performed in children with T1DM.