56-LB: Trauma and Anxiety Effects on Adherence in Pediatric Type 1 Diabetes Mellitus

Background: Psychiatric factors, such as depression, anxiety, and life stressors, have been shown to negatively affect diabetes adherence and glycemic control in children and adolescents. However, less is known about how trauma exposure and symptoms of post-traumatic stress disorder (PTSD) may impact adherence and glycemic control. Objectives: Determine the rates of trauma exposure and PTSD symptoms in patients ages 7-21 with type 1 diabetes (T1DM). Examine the relationship between trauma exposure, PTSD, Anxiety, behavioral adherence and glycemic control. Methods: We enrolled 99 patients (mean age 13.8 ± 3.5 years, 51.5% female) who had been diagnosed with T1DM for at least 6 months and underwent standardized psychiatric screening questionnaires during their clinic visits. HbA1c at goal was defined by HbA1c Results: 38.4% of participants had trauma symptoms and functional impairment. Rates of trauma secondary to accidental injury, medical traumatic stress, natural disaster and witness to family violence were 28.3%, 22.2%, 10.1%, and 6.1%, respectively. Neither trauma exposure nor PTSD predicted diabetes adherence. Anxiety was significantly associated with diabetes nonadherence (p=0.006). The group with suicidal ideation had higher HbA1c compared to the group without suicidal ideation (8.92 ± 1.40 vs. 8.30 ± 1.35, p=0.047). Conclusions: Although trauma was common among young patients with T1DM, other factors, such as anxiety and suicidal ideation, maybe more important indicators of adherence and glycemic control. Disclosure R. Raj: None. M. Nguyen: None. A. Morales: None. A.L. Meadows: None. Funding Children’s Miracle Network/Kentucky Children’s Hospital Research Fund; National Institutes of Health (UL1TR001998)