MON-224 Associations Between Severe Events of Hypo- and Hyperglycemia and Family Well-being

Abstract Disclosure: A. De Arriba: None. E. Civitani: None. M. Ferrer: None. M. Ferrer Lozano: None. S. Quer Palomas: None. J. Nuñez: None. A. Xifra-Porxas: None. F. Mees: None. I. Bilionis: None. R. Berrios: None. L. Fernandez-Luque: Novo Nordisk, This study has been funded by Novo Nordisk, Adhera Health owns the solution used in the study (This applies to all authors from Adhera Health). Introduction: Severe glycemic events pose risks to children with type 1 diabetes (T1D). These events can adversely affect emotional health and elevate caregiver distress. This study examines the associations between severe glycemic events and family well-being. Methods: 90 caregivers (mean age 45y; 22% male) of children with T1D (mean age 10.7 years; 43% male) completed a three-month digital program aimed at supporting their well-being. Data for this study included caregiver self-report measures of well-being (e.g., PANAS, DASS-21), the child’s well-being (KIDSCREEN-10), dietary habits (KIDMED), hypoglycemia (CLARKE), and a T1D knowledge assessment. Continuous glucose monitoring data defined severe hyperglycemia (>250 mg/dL for >180 min) and hypoglycemia (<70 mg/dL for >15 min). Pearson’s correlation tests were used to evaluate relationships between event characteristics (frequency, duration, area) and well-being (padjusted<0.05 considered significant after false discovery rate adjustment - Benjamini-Hochberg method). Time-of-day effects were also examined. Results: Hyperglycemic events correlated with caregiver depressive (r=0.242, p=0.013) and anxiety (r=0.247, p=0.012) symptoms, while better caregiver T1D knowledge correlated with shorter hyperglycemic duration (r=-0.410, p<0.001). Longer hyperglycemic events were linked to reduced KIDSCREEN scores, including increased sadness (r=0.241, p=0.012), poorer school performance (r=-0.293, p=0.003), and reduced attention span (r=-0.289, p=0.003). Greater caregiver T1D knowledge was linked with shorter hypoglycemic duration (r=-0.240, p=0.029). Hypoglycemia events affected children’s academic performance, particularly their ability to pay attention (e.g., duration: r=-0.287, p=0.014). Time-of-day analyses revealed that nighttime hypoglycemic events were associated with worse social (r=-0.300, p=0.044) and academic (r=-0.305, p=0.044) functioning. Discussion: These findings underscore the multifaceted impact of severe glycemic events on family well-being. Hyperglycemia showed stronger associations with caregiver distress and child academic performance than hypoglycemia. Notably, caregivers with higher T1D knowledge demonstrated more effective management of both hyperglycemia and hypoglycemia, highlighting the benefit of educational interventions. Moreover, nighttime hypoglycemia significantly disrupted children’s social and academic functioning. Collectively, this evidence supports the adoption of holistic, family-centered approaches that integrate glycemic management education with psychosocial support to optimize outcomes for children and their caregivers. Presentation: Monday, July 14, 2025