Diabetes Distress Among Adolescents with Type 1 Diabetes: a Systematic Review

Abstract

Diabetes distress (DD) refers to the negative emotions arising from living with diabetes and the burden of self-management. Among adults, the prevalence and significance of DD are well established, but this is not the case among adolescents. This systematic review investigated among adolescents with type 1 diabetes: the prevalence of DD; demographic, clinical, behavioral and psychosocial correlates of DD and interventions that reduce DD. Consistent with adult studies, around one third of adolescents experience elevated DD and this is frequently associated with suboptimal glycemic control, low self-efficacy and reduced self-care. Three measures of DD have been developed specifically for adolescents, as those designed for adults may not be sufficiently sensitive to adolescent concerns. Interventions reducing DD in the short term include strategies such as cognitive restructuring, goal setting and problem solving. Further work is needed to investigate sustainability of effect. Rigorous research is needed to progress this field among adolescents.

A Danish version of self‐efficacy in diabetes self‐management: A valid and reliable questionnaire affected by age and sex

“…This finding is in line with other studies demonstrating that girls have a more negative perception of their illness, more concerns about insulin treatment, more severe diabetes distress (feeling overwhelmed, lacking motivation, and feelings of failure), more worries, and poorer health perceptions . These factors have also been linked to increased levels of depression . Therefore, girls may be more vulnerable than boys and this should be taken into account in the clinical setting.…”

Psychosocial Care for People With Diabetes: A Position Statement of the American Diabetes Association

“…About one-third of adolescents with diabetes develop diabetes distress, which may be associated with declines in self-management behaviors and suboptimal blood glucose levels (44). Parents of children with type 1 diabetes are also prone to diabetes distress (45), which could impact their ability to provide psychological and diabetes management support for their child.…”

12. Children and Adolescents: Standards of Medical Care in Diabetes—2018

“…A Rapid and dynamic cognitive, developmental, and emotional changes occur during childhood, adolescence, and emerging adulthood. Diabetes management during childhood and adolescence places substantial burdens on the youth and family, necessitating ongoing assessment of psychosocial status and diabetes distress during routine diabetes visits (10)(11)(12)(13)(14). Early detection of depression, anxiety, eating disorders, and learning disabilities can facilitate effective treatment options and help minimize adverse effects on diabetes management and disease outcomes (15).…”