The association between depression symptom endorsement and glycemic outcomes in adolescents with type 1 diabetes

Abstract

Objective The prevalence of depression among adolescents with type 1 diabetes is estimated to be 2–3 times higher than in the general population. In adults with type 1 diabetes and depression, short‐term outcomes are worse compared to individuals just diagnosed with type 1 diabetes. This study aims to determine if depressive symptom endorsement is associated with glycemic outcomes and short‐term complications in adolescents with type 1 diabetes. Research Design and Methods Analysis was conducted using electronic medical records from the T1D Exchange Quality Improvement Collaborative. Adolescents with type 1 diabetes, aged 12–18, receiving treatment in a diabetes clinic who had been screened for depression with the PHQ‐9 between 2016 and 2018 were eligible for inclusion. Individuals must have also had HbA1c data available from the day of depression screening and from 10 to 24 weeks after screening; the final sample size was 1714. Results Almost 30% of adolescents endorsed mild or greater (PHQ‐9 ≥ 5) depressive symptoms. Endorsement of mild or greater depressive symptoms was associated with an 18% increased risk of an HbA1c ≥7.5% and a 42% increased risk of an HbA1c ≥9.0% on the day of screener administration. Depressive symptom endorsement was also associated with an 82% increased risk for DKA. Conclusions This study suggests that depression symptoms are associated with an increased risk for elevated HbA1c and short‐term complications. With the rising incidence of type 1 diabetes in youth, routine screening, and appropriate management of depression is needed.

A collaborative comparison of international pediatric diabetes registries

“…Only DPV and SWEET collect CGM raw data files providing information on daily and ambulatory glucose profiles though only for a subgroup of individuals. PROM and/or PREM are currently collected by DPV, NCDR, NPDA, and T1DX‐QI using surveys with questions on health‐related quality of life, psychological well‐being, and experience with diabetes care 25–27 …”

“…using surveys with questions on health-related quality of life, psychological well-being, and experience with diabetes care. [25][26][27] Overall, data completeness within each registry in the pediatric population is high with regard to indicators of diabetes control, daily insulin dose, and documentation of treatment modality (Table 4). With…”

Insulin Glargine 300 U/mL Therapy in Children and Adolescents with Type 1 Diabetes

“…Type 1 DM patients require multiple daily insulin injections (≥ 4 under the basal-bolus regimen), frequent checking of blood glucose levels (> 4 per day) with continuous control of dietary regimen and carbohydrate intake, increased physical activity, and the acquisition of skills aimed at self-managing the disease and using technological devices. All these factors have a significant impact on the patient’s life, particularly children and adolescents; young patients with diabetes and their families often experience a significant level of anxiety which impairs their quality of life (QoL) and results in suboptimal diabetes and glucose control [ 13 ]; depressive symptoms in adolescents with T1DM result in poor glycaemic control and are associated with an increased risk of short-term complications [ 14 ].…”

A New Potential Antidepressant: Dexmedetomidine Alleviates Neuropathic Pain-Induced Depression by Increasing Neurogenesis in the Hippocampus

“…The lifetime prevalence of depressive disorders is approximately 6.5-21% [1], and this incidence rate is predicted to become the second leading cause of disability worldwide [2]. Studies have shown that various physical sicknesses and disabilities can induce a depressive phenotype [3][4][5][6]. Among the detected causes, chronic pain is one of the main triggers.…”