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Diabetes distress, depression, and future glycemic control among adolescents with type 1 diabetes

  • Cecilia P. Damilano ORCID logo EMAIL logo , K. Ming Chan Hong , Bethany A. Glick , Manmohan K. Kamboj and Robert P. Hoffman ORCID logo
Published/Copyright: February 20, 2025
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 4

Abstract

Objectives

Increased diabetes distress and depression in adolescents with type 1 diabetes (T1D) are associated with poor glycemic control but it is not known whether they predict future glycemic control.

Methods

Patient Health Questionnaire (PHQ-9) and Problem Areas in Diabetes-Teen version (PAID-T) scores were given to 275 adolescents (age 13–17 years) with T1D. Robust rank order multivariate regression analysis was used to assess how age, duration of diabetes diagnosis, HbA1c at screen, PHQ-9 score, PAID-T screen, and insurance status predicted HbA1c at 1, 2, and 3 years after, and the changes in HbA1c over time.

Results

HbA1c and changes in HbA1c after one year were related to baseline HbA1c. At 2 and 3 years HbA1c was related to the initial HbA1c [β: 0.64 (95 % CI 0.53–0.75) and β: 0.47 (95 % CI 0.33–0.61), respectively], and to PHQ9 at screening [β: 0.07 (95 % CI 0.01–0.14) and β: 0.11 (95% CI 0.03–0.18), respectively]. Relationships were also demonstrated between PHQ9 and changes HbA1c after 2 and 3 years [β: 0.07 (95% CI 0.01–0.14) and β: 0.11 (95 % CI 0.03–0.18), respectively]. PAID-T score was not related to future glycemic control or changes in glycemic control at any time. Insurance status (private 1, public 2) also predicted future glycemic control and changes in HbA1c at 1, 2, and 3 years too.

Conclusions

Higher PHQ9 scores and public insurance predict worsening glycemic control over 3 years in adolescents with T1D while increased diabetes distress does not.

Keywords: depressed mood; diabetes burn out; glycemic control predictors; pediatric; T1D
Corresponding author: Cecilia P. Damilano, MD, Assistant Professor of Pediatrics, Division of Endocrinology, Nationwide Children’s Hospital, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA, E-mail:

Acknowledgments

The authors would like to express our gratitude to Nationwide Children’s Hospital for the ongoing support, and to the participants’ families for letting us take care of their children.

  1. Research ethics: Appropriate approval from the Institutional Review Board had been previously obtained (IRB 18-00130). Our study was conducted in accordance with the Declaration of Helsinki (as revised in 2013).

  2. Informed consent: Not applicable (chart review).

  3. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Use of Large Language Models, AI and Machine Learning Tools: None declared.

  5. Conflict of interest: The authors state no conflict of interest.

  6. Research funding: None declared.

  7. Data availability: Not applicable.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/jpem-2024-0524).

Received: 2024-10-30
Accepted: 2025-01-29
Published Online: 2025-02-20
Published in Print: 2025-04-28

© 2025 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Diabetes distress, depression, and future glycemic control among adolescents with type 1 diabetes
  4. Is oxytocin related to psychiatric symptoms in adolescents with obesity?
  5. Associations between body mass index and sleep duration in Brazilian children and adolescents: the moderating role of screen time
  6. The transfer of care experience in young adults with type 1 diabetes
  7. Assessing the efficacy of a hybrid closed loop system in a racial-ethnic minority cohort of children and adolescents with type 1 diabetes
  8. Do children with type 1 diabetes mellitus remain protected against hepatitis B?
  9. Influence of excess weight on metabolic risk factors in Argentinian preschool children
  10. Causal associations between childhood obesity and delayed puberty or height: a bidirectional two-sample Mendelian randomization study
  11. Differentiating true precocious puberty and puberty variants in consecutive 275 girls: a single center experience
  12. Development of bone mineral density and content in children with cerebral palsy: a retrospective, longitudinal study
  13. Insights in non-CAH pediatric primary adrenal insufficiency: a single-center experience from India
  14. Effect of empagliflozin treatment on laboratory and clinical findings of patients with glycogen storage disease type Ib: first study from Türkiye
  15. Clinical and laboratory characteristics of propionic acidemia in a Turkish cohort
  16. Short Communication
  17. The impact of the COVID-19 pandemic on DKA severity in Black and White pediatric patients
  18. Case Reports
  19. Evinacumab as an adjunct to lipid apheresis in an infant with homozygous familial hypercholesterolemia
  20. DNA ligase IV deficiency identified in a patient with hypergonadotropic hypogonadism: a case report
  21. Moebius syndrome and hypopituitarism: a case of multiple pituitary hormone deficiency and revision of the literature
https://doi.org/10.1515/jpem-2024-0524
Keywords for this article
depressed mood; diabetes burn out; glycemic control predictors; pediatric; T1D

Articles in the same Issue

  1. Frontmatter
  2. Original Articles
  3. Diabetes distress, depression, and future glycemic control among adolescents with type 1 diabetes
  4. Is oxytocin related to psychiatric symptoms in adolescents with obesity?
  5. Associations between body mass index and sleep duration in Brazilian children and adolescents: the moderating role of screen time
  6. The transfer of care experience in young adults with type 1 diabetes
  7. Assessing the efficacy of a hybrid closed loop system in a racial-ethnic minority cohort of children and adolescents with type 1 diabetes
  8. Do children with type 1 diabetes mellitus remain protected against hepatitis B?
  9. Influence of excess weight on metabolic risk factors in Argentinian preschool children
  10. Causal associations between childhood obesity and delayed puberty or height: a bidirectional two-sample Mendelian randomization study
  11. Differentiating true precocious puberty and puberty variants in consecutive 275 girls: a single center experience
  12. Development of bone mineral density and content in children with cerebral palsy: a retrospective, longitudinal study
  13. Insights in non-CAH pediatric primary adrenal insufficiency: a single-center experience from India
  14. Effect of empagliflozin treatment on laboratory and clinical findings of patients with glycogen storage disease type Ib: first study from Türkiye
  15. Clinical and laboratory characteristics of propionic acidemia in a Turkish cohort
  16. Short Communication
  17. The impact of the COVID-19 pandemic on DKA severity in Black and White pediatric patients
  18. Case Reports
  19. Evinacumab as an adjunct to lipid apheresis in an infant with homozygous familial hypercholesterolemia
  20. DNA ligase IV deficiency identified in a patient with hypergonadotropic hypogonadism: a case report
  21. Moebius syndrome and hypopituitarism: a case of multiple pituitary hormone deficiency and revision of the literature
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