Post-traumatic stress among children living with type 1 diabetes and their caregivers

Objectives: There are mixed findings regarding the impact of sub-diagnostic levels of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) on diabetes-related outcomes for children living with type 1 diabetes (T1D) mellitus and their caregivers. We examined the prevalence and correlates of PTSS and PTSD at a pediatric diabetes center. Material and Methods: From June 2022 to July 2024, we enrolled children aged 2–17 years who had been living with T1D >12 months and their caregivers. Children completed the Child PTSD Symptom Scale (CPSS), and caregivers completed the PTSD Checklist (PCL). A score of ≥31 on CPSS/PCL indicated “probable PTSD”. Children and caregivers were asked if T1D was thought about when completing the CPSS/PCL and if reported symptoms impacted T1D management. Demographic and clinical data were obtained from electronic medical charts. Results: Of 87 youths (mean age 12.7 ± 3.6 years, T1D duration 4.6 ± 3.8 years, and HbA1c 7.3 ± 1.2), 60 children completed CPSS-5-SR. Forty-one percent reported thinking about T1D while completing the CPSS, 12% felt symptoms impacted T1D self-management, and 10% met probable PTSD criteria. Among 86 caregivers, 35% reported thinking about T1D while completing the PCL, 11% felt symptoms impacted T1D management, and 9% met probable PTSD criteria. The correlation between caregiver and youth PTSS was 0.39 ( n = 59, p = 0.002). Conclusion: Among children living with T1D and their caregivers, the prevalence of probable PTSD was about twice as high as the United States general population. Notably, children with diabetes ketoacidosis at diagnosis more frequently had caregivers with probable PTSD. The high use of hybrid close loop (HCL) and diabetes devices may mitigate the potential for PTSS or PTSD.