OBJECTIVES: The increased use of digital medical devices in pediatric diabetes management puts increased digital health literacy expectations on parents. We aimed to assess parents’ digital health literacy, the health status of their children with Type 1 diabetes mellitus (T1DM) and explore the determinants of children’s glucose control status.

METHODS: A cross-sectional survey was performed among 121 dyads of parents and T1DM children aged 8-15 years attending a university pediatric diabetes center. Parents’ digital/health literacy was measured with the eHEALS and New Vital Sign (NVS) tools, respectively, alongside the Hypoglycaemia Fear Survey (HFS) and Parental Self-Efficacy Scale for Diabetes Management (PSESDM) scales. Glucose control status (past 6 months average HbA1C level) was recorded and children completed the Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales and EQ-5D-3L-Y measures. Determinants of children’s HbA1C level were investigated by multiple linear regression analysis.

RESULTS: Diabetes treatment was pen (N=31), pen+sensor (N=48), insulin pump (N=1), and insulin pump+sensor (N=41). Parents’ average scores were: eHEALS 31.6 (±4.6), NVS 4.4 (±1.8), HFS 41.2 (±12.8), and PSESDM 32.6 (±5.5). Children’s average HbA1C was 7.6 (±1.3), while PedsQL and EQ-5D-3L-Y were 80.4 (±13.5) and 0.93 (±0.10), respectively. eHEALS, NVS, PSESDM, and HbA1C differed significantly across treatment subgroups but PedsQL and EQ-5D-3L-Y did not. Children’s HbA1C score was significantly associated with EQ-5D-3L-Y index score, diabetologist’s opinion on the difficulty of managing the disease, self-reported impact of the disease on parents’ life, hyperglycemic and other adverse events in the past 3 months, but not with parents’ literacy scores.

CONCLUSIONS: Results of this first explorative study suggest that parents’ digital health literacy might affect the treatment choice in pediatric T1DM. However, no associations with disease outcomes were found. Further prospective studies are encouraged to explore whether eHEALS could be used as a predictor of parents’ capabilities to accept and cope with different treatment modalities.