ISPAD Clinical Practice Consensus Guidelines 2018: Psychological care of children and adolescents with type 1 diabetes

Abstract

Recent literature has been reviewed and new research findings as well as systematic reviews show the important role in management of type 1 diabetes in children and adolescents of:1) Depression and diabetes distress; 2) Disordered eating behaviors; 3) Cognitive functioning and school performance; 4) Parental distress, coping, and demographic factors; 5) Stress and coping; 6) Factors affecting quality of life, including resiliency; and 7) Psychosocial and behavioral intervention studies to improve glycemic control, diabetes management behaviors, and psychosocial functioning. Executive Summary and RecommendationsThe following summary and recommendations build upon the previous ISPAD Guidelines (1) and are consistent with the latest statements and guidelines issued by the American Diabetes Association (2), Australia (APEG -Clinical Practice Guidelines, www.nhmrc.gov.au/publications/pdf/cp102.pdf),Canada (www.diabetes.ca/cpg2003),and the UK (www.nice.org.uk/pdf/type1diabetes).Young people with diabetes appear to have a greater incidence of depression, anxiety, psychological distress and eating disorders compared to their peers without diabetes (A).Children and young people with chronic poor metabolic control, including recurrent DKA, are more likely to have underlying psychosocial problems or psychiatric disorders than children in good metabolic control (A, B).1. Resources should be made available to include professionals with expertise in the mental and behavioral health of children and adolescents within the interdisciplinary diabetes health care team.These mental health specialists should include psychologists, social workers, and psychiatrists (E).Mental health professionals should be available to interact not only with patients and families at clinic visits to conduct screening and more complete assessments of psychosocial functioning, but also to support the diabetes team in the recognition and management of mental health and behaviorThis article is protected by copyright.