Design: Survey.

Population, Sample, Setting, Years: 51 diabetic adults (18 Caucasians, 16 African Americans, 16 Hispanics, 1 Native American) from nine clinics, acknowledging a child caregiver, 2001-2003.

Variables Studied: Race/ethnicity, sex, age, diabetes type, relationship to child, nature and duration of caregiving, child preparation for caregiving.

Method: Adults completed an investigator-developed survey in English or Spanish (test-retest reliability .987) as written questionnaire or interview by native Spanish speaker. Data were analyzed descriptively.

Findings: The prevalence of child caregiving for 287 adults was 15.7% with no significant difference by ethnicity. Children (63% female) ranged in age from 5 to 18 (M 13.3); 81% were adults' children or grandchildren. Caregiving began at a mean age of 11 with a range of 3 to 17. Duration of caregiving ranged from 2 weeks to 10 years. Children provided a mean of 3.8 forms of assistance (range 1 to 10). ANOVA with Tukey post hoc comparisons revealed that Hispanic children provided the highest mean number of services (5) and African American children the lowest (2.8). Most children helped daily or several times a week, 55% with no instruction about diabetes.

Conclusions: Children of both sexes and four racial/ethnic groups provided a wide range of assistance to diabetic adults, often with no preparation. The complexity of care by children as young as five and children's involvement in diabetic emergencies was frightening.

Implications: The prevalence of child caregiving for diabetic adults is high enough across ethnic groups that diabetes nurses should inquire about its presence. The positive and negative impacts of such caregiving on children and the issue of how much caregiving by children is too much need further exploration.

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