Relationship between depressive and anxiety symptoms and fear of hypoglycemia among adolescents and adults with type 1 diabetes mellitus

Zeitoun, Mohammed H.; Reheem, Ali A. Abdel; Kharboush, Ibrahim; Sheshtawy, Hesham; Assad, Dalia H.; Feky, Amr Y. El

doi:10.1016/j.pcd.2023.03.002

Cited by 3 publications

(2 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Low blood sugar and anxiety are linked, but the relationship is complicated. Symptoms of low blood sugar can mirror anxiety's symptoms, or worsen existing anxiety [4,60]. These patients may also experience anxiety about regulating their blood sugar levels.…”

Section: Discussionmentioning

confidence: 99%

Psychological Alterations in Youths with Type I Diabetes: Associations with Salivary Cortisol Concentration

El Mlili,

Ahabrach,

Bahri

et al. 2023

Medicina

View full text Add to dashboard Cite

Background and Objectives: Type 1 diabetes mellitus (T1DM) is one of the most common chronic diseases in children and adolescents, and is associated with stress and other psychological alterations. This study aims to assess psychological and sleep disorders and health-related quality of life in young people with T1DM and to determine the relationship between these parameters and levels of salivary cortisol, a hormone widely associated with stress and several psychological symptoms. Materials and Methods: In our cross-sectional study performed in 60 Moroccan children and adolescents with T1DM, detailed psychological evaluations were performed to assess symptoms of anxiety, attention-deficit hyperactivity disorder (ADHD), sleep quality and diabetes-specific quality of life (using the RCMAS-2, ADHD rating scale, Pittsburgh scale and the DQoL scale, respectively), and cortisol concentration was measured from saliva samples taken mid-morning. Results: A total of 60 children and adolescents with T1DM were recruited. The mean age was 11.05 ± 0.35 (6–17). The mean salivary cortisol level in ng/mL was 4.7 ± 0.49 (0.7–20.2) and was significantly associated with an anxiety RCMAS2 score for the Worry subdomain and DQoL subdomain “Anxiety”. Linear regression analysis showed that salivary cortisol was significantly higher in girls compared to boys (p = 0.004) (beta coefficient: 3.384 CI95%: 1.137–5.630) and with Hb1AC level as a continuous variable (p = 0.0001) (beta coefficient: 1.135 CI95%: 0.509–1.760). The other variables included in the model were not significant (p > 0.05). There was an association between salivary cortisol concentration with anxiety RCMAS2 score for Worry subdomain and QoL sub-domain “Anxiety”. Still, a significant (p = 0.018) association emerged for anxiety RCMAS2 score Worry subdomain and QoL anxiety subdomain (p = 0.044). Conclusions: Children and adolescents with T1DM experienced significantly elevated symptoms of anxiety and sleep disturbances, particularly in girls, and frequent symptoms of ADHD, particularly in boys. Salivary cortisol concentration collected in the morning is associated with anxiety burden but not with other psychological alterations. Further studies are needed to clarify the associations between salivary cortisol concentration and anxiety in type 1 diabetes in order to propose the hormone as a biomarker for interventions aimed to reduce anxiety levels in these patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Psychological Alterations in Youths with Type I Diabetes: Associations with Salivary Cortisol Concentration

El Mlili,

Ahabrach,

Bahri

et al. 2023

Medicina

View full text Add to dashboard Cite

show abstract

“…It is important to evaluate the psychosocial needs of young people with diabetes and their families when patients start using AID systems and during follow-up ( 87 ), establishing realistic expectations about the pros and cons of AID systems ( 86 ). Therefore, technological advances must be accompanied by well-timed training and adequate and continuous support ( 87 , 88 ) and education.…”

Section: Fear Of Hypoglycemia and Psychological Impactmentioning

confidence: 99%

Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Zucchini,

Tumini,

Scaramuzza

et al. 2024

Front. Endocrinol.

View full text Add to dashboard Cite

There has been continuous progress in diabetes management over the last few decades, not least due to the widespread dissemination of continuous glucose monitoring (CGM) and automated insulin delivery systems. These technological advances have radically changed the daily lives of people living with diabetes, improving the quality of life of both children and their families. Despite this, hypoglycemia remains the primary side-effect of insulin therapy. Based on a systematic review of the available scientific evidence, this paper aims to provide evidence-based recommendations for recognizing, risk stratifying, treating, and managing patients with hypoglycemia. The objective of these recommendations is to unify the behavior of pediatric diabetologists with respect to the timely recognition and prevention of hypoglycemic episodes and the correct treatment of hypoglycemia, especially in patients using CGM or advanced hybrid closed-loop systems. All authors have long experience in the specialty and are members of the Italian Society of Pediatric Endocrinology and Diabetology. The goal of treating hypoglycemia is to raise blood glucose above 70 mg/dL (3.9 mmol/L) and to prevent further decreases. Oral glucose at a dose of 0.3 g/kg (0.1 g/kg for children using “smart pumps” or hybrid closed loop systems in automated mode) is the preferred treatment for the conscious individual with blood glucose <70 mg/dL (3.9 mmol/L), although any form of carbohydrate (e.g., sucrose, which consists of glucose and fructose, or honey, sugary soft drinks, or fruit juice) containing glucose may be used. Using automatic insulin delivery systems, the oral glucose dose can be decreased to 0.1 g/kg. Practical flow charts are included to aid clinical decision-making. Although representing the official position of the Italian Society of Pediatric Endocrinology and Diabetology (ISPED), these guidelines are applicable to the global audience and are especially pertinent in the era of CGM and other advanced technologies.

show abstract

Expert consensus recommendations on the evaluation and management of hypoglycemia in diabetes: DGENius Group Diabetes India

Dey,

Gokalani,

Kale

et al. 2024

JODB

View full text Add to dashboard Cite

Background and Aim: Hypoglycemia, marked by low blood glucose levels, presents significant challenges in diabetes care. This review outlines the evidence-based recommendations formulated by the DGENius Experts Consensus Group for managing hypoglycemia in people with diabetes. The goal was to furnish well-defined, evidence-based recommendations for addressing and comprehending hypoglycemia within diverse contexts, encompassing diabetes management, and various medical conditions. Materials and Methods: The consensus statement was crafted through an extensive literature review involving peer-reviewed articles, clinical guidelines, and relevant publications. A diverse panel of experts with broad knowledge and experience convened for structured deliberation, followed by multiple rounds of rigorous review and meetings to reach the final consensus statement. Results: The consensus introduces the importance of effective hypoglycemia in people with diabetes management, addressing both type 1 and type 2 diabetes mellitus separately, with tailored recommendations. It also covers impact of hypoglycemia on cardiovascular health and related recommendations. The document extends its scope to co-existing medical conditions, encompassing chronic renal dysfunction, hepatic and neoplastic disorders; hypoglycemia in specialized circumstances, such as during physical exertion, administration of oral antidiabetic agents, fasting periods, hospital-based care, reduced symptomatic awareness, nocturnal episodes, alcohol intake, pregnancy, and following metabolic surgical interventions; hypoglycemia in the context of nonantidiabetic medications; and hypoglycemia among the elderly. Quality of life and patient awareness are emphasized, and the statement concludes with prevention, treatment, and technology utilization recommendations. Conclusion: This comprehensive consensus statement is designed to guide healthcare professionals in managing hypoglycemia optimally. The goal is to heighten awareness of this critical condition, improve patient outcomes, and enhance their quality of life.

show abstract

Relationship between depressive and anxiety symptoms and fear of hypoglycemia among adolescents and adults with type 1 diabetes mellitus

Cited by 3 publications

References 32 publications

Psychological Alterations in Youths with Type I Diabetes: Associations with Salivary Cortisol Concentration

Psychological Alterations in Youths with Type I Diabetes: Associations with Salivary Cortisol Concentration

Recommendations for recognizing, risk stratifying, treating, and managing children and adolescents with hypoglycemia

Expert consensus recommendations on the evaluation and management of hypoglycemia in diabetes: DGENius Group Diabetes India

Contact Info

Product

Resources

About