Insulin Pumps in Type 1 Diabetes with Mental Disorders: Real-Life Clinical Data Indicate Discrepancies to Recommendations

Prinz, Nicole; Bächle, Christina; Becker, Marianne; Berger, Gabriele; Galler, Angela; Haberland, Holger; Meusers, Michael; Mirza, Joaquina; Plener, Paul L.; Sengbusch, Simone von; Thienelt, Michaela; Holl, Reinhard W.

doi:10.1089/dia.2015.0180

Cited by 31 publications

(35 citation statements)

References 14 publications

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“…There was a high prevalence in social phobia, panic disorders or agoraphobia, psychological distress, OCD and GAD in type 1 patients with diabetes compared with type 2 [14][15][16]21,31,32]. Type 1 population with diabetes appears since childhood and it possible that increase in glucose and indicated as predictive of high anxiety [18,[23][24][25][26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 99%

“…As the results of this study showed, both types require a warning for the treatment of that emotional disturbance [14,15,26,32]. Worry about the future is common in patients with diabetes [14][15][16]21,31,32,33]. All of the time, they can get in troubles with effort, money, and stress have an emotional influence on individual stability and introduce psychiatry disorders.…”

Section: Discussionmentioning

confidence: 99%

“…When insulin is not working well, high blood sugar levels build in the body and the consequence of that is comorbidity in several areas, eyes, heart and mental disorders. The association between depression symptoms and mood disorders with diabetes was found in several studies [14][15][16][17][18][20][21][22][23]26,28,30,32,42]. Specifically were cited in studies there were 18.2% participants with Dysthymia [14,17,18].…”

Section: Discussionmentioning

confidence: 99%

“…The highest anxiety scores were more prevalent in women, with lower social status and income, chronic disease, depression and poor sleep quality. Finally, Prinz et al [21], screened 48700 patients with diabetes have 41.5% of depression, anxiety/obsessive-compulsive disorder (41.4%) or needle phobia (75.8%) compared with patients without diabetes (34.6%) had significantly correlation (p<0.05). Patients who had not mental disorders presented depression scores (8.2%), anxiety/ OCD (6.0%), or needle phobia (5.3%) [21].…”

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confidence: 98%

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Mental Disorders in Subjects with Diabetes: A Systematic Review

Acc¹,

Vm²,

Mg³

et al. 2017

Health Care Current Reviews

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Depression has been a common comorbidity and reduces the quality of life, the poor glycemic control and consequently worsens the diabetes course. The goals of this systematic review are searching of a population who have higher mental disorders in type 1 and 2 patients with diabetes and if there is a direct relationship between glycemic control and psychiatric disorders in this population. A total of 2527 references, review and review articles were excluded, 19 scientific studies were selected: 9 cross-sectional studies, 6 prospective observational studies, 3 retrospective observational studies, and 1 case-control study. Depression and anxiety have a high prevalence in subjects with diabetes. Therefore, the relevance of this study is showing that those mental disorders have a direct correlation in both types of diabetes treatments and decrease the quality of life. Also, the rates of depression could be up to three times higher in patients with type 1diabetes and twice as high in individuals with type 2 diabetes compared with the general population. Patients live in fear of complications from diabetes over the long term and also have damage due to the high psychiatric comorbidity of these chronic patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 98%

See 2 more Smart Citations

Mental Disorders in Subjects with Diabetes: A Systematic Review

Acc¹,

Vm²,

Mg³

et al. 2017

Health Care Current Reviews

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“…fluoxetine and Prozac) as the use of antidepressant medication is strongly associated with depressed mood. This method has been applied successfully in previous studies on comorbid psychiatric disorders .…”

Section: Methodsmentioning

confidence: 99%

Comparative characteristics of older people with type 1 diabetes treated with continuous subcutaneous insulin infusion or insulin injection therapy: data from the German/Austrian DPV registry

Grammes

Küstner²,

Dapp³

et al. 2020

Diabet. Med.

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Aim To compare clinical characteristics and outcomes in adults with type 1 diabetes aged ≥ 60 years using continuous subcutaneous insulin infusion (CSII) vs. insulin injection therapy. Further, to determine the percentage of older adults with type 1 diabetes using CSII.Research design and methods Retrospective study using data of the Diabetes Prospective Follow-up Registry (DPV). Including percentage CSII use from 2008 to 2018, and the characteristics of 9547 individuals extracted from the DPV in March 2019 (N = 1404 CSII; N = 8143 insulin injection therapy). Wilcoxon rank sum tests were used for continuous variables and chi-square tests for categorical variables to compare clinical characteristics of people using CSII vs. insulin injection therapy. Adjusted analyses used generalized linear models to compare diabetes-related outcomes.Results CSII usage has increased in older adults (from 12% in 2008 to 23% in 2018). After adjustment, CSII was associated with lower HbA 1c [60.7 mmol/mol (7.7 AE 0.1%) vs. 62.8% (7.9 AE 0.1%)], lower daily insulin dose (0.49 AE 0.02 vs. 0.61 AE 0.01 IU/kg), fewer days in hospital (8.1 AE 0.12 vs. 11.2 AE 0.11 days/person-year), fewer severe hypoglycaemic events (0.16 AE 0.02 vs. 0.21 AE 0.03 events/person-year) and fewer diabetic ketoacidosis (0.06 AE 0.01 vs. 0.08 AE 0.01 events/person-year). Individuals on CSII showed lower rates of microalbuminuria and also have a diagnosis of depression and neuropathy.Conclusions A growing number of older adults are using insulin pumps. Older age in itself should not be seen as a contraindication for CSII.

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Prevalence of disordered eating behaviors in adolescents with type 1 diabetes: Results of multicenter Italian nationwide study

Troncone

Affuso

Cascella

et al. 2022

Intl J Eating Disorders

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Objective To assess the prevalence of disordered eating behaviors (DEBs) in a large sample of Italian adolescents with type 1 diabetes and to explore potential demographic, clinical, and psychological differences (understood as emotional and behavioral problems) among adolescents with and without DEBs. Method Adolescents (11–19 years) with type 1 diabetes completed the Diabetes Eating Problems Survey‐revised (DEPS‐r) and the Youth Self Report (YSR). Demographic and clinical data were also collected. Results Of 690 adolescents with type 1 diabetes (mean age 14.97 ± 1.81, n = 337 girls) assessed in this study, 28.1% (21% boys, 35% girls) were DEPS‐r positive (score ≥ 20). Girls had higher DEPS‐r total scores (p < .0001, d = .42) than boys, although no age differences were found in mean DEPS‐r total scores (p = .961). In both genders, adolescents with DEBs had significantly higher zBMI (p < .0001, d = .52) and HbA1c values (p < .0001, d = .54) and showed more emotional and behavioral problems (both as internalizing and externalizing problems) than those without DEBs (all p < .0001). These differences were largely confirmed in all age groups. Adolescents reporting insulin misuse had higher HbA1c values (p = .001, d = .26), higher DEPS‐r mean scores (p < .0001, d = 1.07), and greater psychological problems (all p < .001) than those who did not. Discussion DEBs are prevalent among adolescents with type 1 diabetes, and those with eating problems showed adverse clinical and psychological conditions. Routine screening for DEBs and of general psychological condition should be a fundamental part of diabetes care, especially during adolescence. Public significance statement This nationwide study indicated that DEBs are common in adolescents with T1D, and those suffering from them show poorer clinical conditions and higher emotional and behavioral problems. As such, it offers important contributions for those working with EDs and in the T1D field, as it provides a deeper understanding of the co‐occurring DEBs–emotional/behavioral problems in youths with T1D and highlights the importance of continuous monitoring of their psychological condition by a multidisciplinary team.

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Insulin Pumps in Type 1 Diabetes with Mental Disorders: Real-Life Clinical Data Indicate Discrepancies to Recommendations

Abstract: In routine diabetes care, CSII use and discontinuation vary widely among T1D patients with mental disorders and indicate clear differences from the latest recommendations.

Cited by 31 publications

References 14 publications

Mental Disorders in Subjects with Diabetes: A Systematic Review

Mental Disorders in Subjects with Diabetes: A Systematic Review

Comparative characteristics of older people with type 1 diabetes treated with continuous subcutaneous insulin infusion or insulin injection therapy: data from the German/Austrian DPV registry

Prevalence of disordered eating behaviors in adolescents with type 1 diabetes: Results of multicenter Italian nationwide study

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