Certain mental health issues are linked to worse diabetes control in children and young adults with type 1, while other psychological issues apparently are not linked to diabetes control, according to a new study published in the journal Diabetes Spectrum.
There is a well-established link between depression and diabetes, but this link doesn’t appear to be simple or straightforward. For example, past research has shown that among children with diabetes, a longer diabetes duration is linked to depression only in those with type 2, while among children in good overall health, those with type 1 are more prone to depression than those with type 2. When it comes to adults, having type 2 diabetes or even prediabetes is linked to a higher risk for depression, but certain support interventions can reduce the risk for depression in people with diabetes. And while depression is linked to a higher risk for death in older adults with type 2, taking an antidepressant is linked to a reduced death risk in people with diabetes and depression.
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For the latest study, researchers were interested in looking at whether different forms of trauma — as well as the lasting effects of trauma, as seen in post-traumatic stress disorder (PTSD) — were linked to worse diabetes control. They also looked at the link between other mental health issues, like depression and anxiety, and adherence to recommended blood glucose monitoring. The study participants were 258 people ages 7 to 21 with type 1 diabetes, who completed standard psychiatric screening questionnaires during clinic visits as part of the study.
The researchers found that 66% of the participants had experienced exposure to trauma, and 38% had symptoms consistent with functional impairment related to PTSD. Rates of trauma from specific causes were 28% for accidental injury, 22% for medical traumatic stress, 10% for natural disasters, and 6% for witnessing family violence. But the researchers found no link between PTSD, anxiety, or depression symptoms and worse adherence to recommended blood glucose monitoring. They did find, though, that anxiety disorders and significant school avoidance were linked to reduced adherence to blood glucose monitoring recommendations. In addition, participants who reported suicidal ideation had a higher average A1C level (a measure of long-term blood glucose control) than those who didn’t report suicidal thoughts.
As reported in a Healio article on the study, the researchers noted that these results show the importance of providing multidisciplinary care to children with diabetes — including psychiatric care and psychological support as needed. Not only could this help improve the children’s quality of life, but intervening to support mental health could also improve diabetes-related outcomes. At the very least, the researchers wrote, health care providers who work with children with diabetes should ask about stressful experiences, and follow up with screening questionnaires and possible referral to a mental health professional as they feel is appropriate.
Want to learn more about raising a child with type 1 diabetes? Read “The Type 1 Diabetes Diagnosis,” “Type 1 Diabetes at School: What Personnel Need to Know,” and “Helping a Student-Athlete With Type 1 Diabetes.”