Depressive Symptoms in Children and Adolescents With Type 1 Diabetes

Abstract

Depression in children and adolescents with type 1 diabetes has been associated with negative diabetes-related health outcomes such as poorer glycemic control (1–5) and recurrent diabetic ketoacidosis (DKA) admissions (6,7). While mechanisms that link depression and suboptimal health outcomes are poorly understood (8), it is apparent that the chronicity of type 1 diabetes and the demands of management provide a fertile environment for adjustment problems. Our aim was to investigate depressive symptoms in children and adolescents with type 1 diabetes and their association with demographic, diabetes-specific, and family-functioning variables. Study participants were 145 youth and their parents (107 mothers, 35 fathers, and 3 guardians) who received care at a pediatric diabetes center from a multidisciplinary team. The sample of 145 youth (56% female) had a mean age of 14.9 ± 2.3 years (range 10–18). Duration of type 1 diabetes was 8.3 ± 3.5 years, and mean HbA1c (A1C) was 8.7 ± 1.4%. At the time of the participant’s clinic appointment, a trained research assistant obtained written informed consent and assent and then administered questionnaires. This sample of 145 parent-youth dyads represented 88% of the families approached. Insulin dose and frequency of insulin injections were documented by the youth’s medical provider. Frequency of blood glucose monitoring (BGM) was documented through meter downloads and parent report. Each participant provided a sample of blood for A1C, measured by high-performance liquid chromatography (reference range 4.0–6.0%, Tosoh 2.2; Tosoh Bioscience, South San Francisco, CA). Depressive symptoms in youth were assessed with the Children’s Depression Inventory (CDI) (9), a self-report questionnaire consisting of 27 …