Diabetes distress linked to self-care and HbA1c in adolescents with diabetes
medwireNews: Diabetes distress is more common than depression in adolescents with diabetes and is significantly associated with less frequent blood glucose monitoring and higher glycated hemoglobin (HbA1c) levels, study findings indicate.
Speaking at the 79th ADA Scientific Sessions in San Francisco, California, USA, study co-author Hiba Abujaradeh (University of Pittsburgh, Pennsylvania, USA) said the findings highlight the importance of screening adolescents with diabetes for diabetes distress.
Abujaradeh explained that although diabetes distress and depressive symptoms have been shown to predict self-care behaviors and glycemic control in adults, little work has been done among adolescents.
To address this, she and her team reviewed data from the Patient-Reported Outcomes Project for 103 young people aged 12–21 years (mean 15.9 years) with diabetes (73% type 1) who had been living with the disease for 4.8 years, on average, and had a mean HbA1c level of 8.6% (70 mmol/mol).
Among the participants, 22% had moderate-to-severe levels of diabetes distress, defined as a mean score of 3 or higher on the 2-item Diabetes Distress Screening (DDS2) tool (mean=4.3), and 7% had moderate-to-severe depression according to a score of 10 or more on the 9-item Patient Health Questionnaire (mean=2.9).
Abujaradeh and team found that although diabetes distress and depression significantly and positively correlated with each other, only diabetes distress correlated with self-care and glycemic control.
Specifically, there was a significant inverse correlation between diabetes distress and the average number of daily blood glucose monitoring checks, which served as a surrogate marker for self-care, after adjustment for baseline demographic and clinical variables as well as levels of diabetes distress and depressive symptoms.
By contrast, the adjusted analysis showed that diabetes distress was positively associated with HbA1c levels.
The researchers also found that levels of diabetes distress and depressive symptoms were significantly higher in girls than boys but were not associated with diabetes type.
Abujaradeh said it was “not surprising” that diabetes distress “had stronger associations with diabetes biobehavioral variables than depressive symptoms” because the outcomes of the DDS2 tool are diabetes-specific.
“However, it shows that simply screening for depression may miss an important aspect of the psychosocial health of adolescents with diabetes.”
She concluded: “Appropriate intervention should follow positive screens of [diabetes distress] to improve adolescents’ diabetes-related variables.”
By Laura Cowen
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