Coping Strategies, Quality of Life, and Glycemic Control among Adolescents with Diabetes Distress

Objective: Up to half of adolescents with type 1 diabetes (T1D) experience diabetes distress (DD) which has been associated with lower health-related quality of life (HRQOL) and suboptimal glycemic control. The ways in which adolescents respond to DD may serve as a risk or protective factor for these outcomes, but few studies have examined the coping strategies adolescents use to manage DD. Methods: Participants included 198 adolescents with elevated DD who completed baseline data for a randomized controlled trial (Mage 15.3±1.4, 58% female, 58% Non-Hispanic White, MT1D duration 6.4±3.7 years, MA1c = 9.2±2.2%). Adolescents completed the Responses to Stress Questionnaire, assessing coping strategies related to diabetes stressors. Subscales include 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 the Type 1 Diabetes and Life (T1DAL) measure of HRQOL. HbA1c data were gathered from medical records or at-home kits. The association of coping strategies with HRQOL and HbA1c was examined among adolescents experiencing DD. Results: Bivariate correlations revealed that higher use of primary and secondary engagement coping strategies was associated with higher HRQOL (r=0.58; r=0.58, respectively), while higher use of disengagement coping strategies was associated with lower HRQOL (r=−0.51). Higher use of primary engagement coping strategies was associated with lower HbA1c (r=−0.21) while higher use of disengagement strategies was associated with higher HbA1c (r=0.17); all p<0.05. Discussion: Among a diverse group of adolescents experiencing DD, the use of engagement coping strategies was significantly correlated with higher HRQOL and lower HbA1c. These results highlight the value in promoting engagement coping strategies and discouraging the use of disengagement coping strategies among adolescents experiencing DD. Disclosure E.Straton: None. H.Inverso: None. R.Streisand: None. S.S.Jaser: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R01DK121316)