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Psychosocial care in diabetes


Diabetes distress and psychological comorbidities

Diabetes distress among adolescents with type 1 diabetes: A systematic review

This systematic review investigated the epidemiology of diabetic distress in adolescents with type 1 diabetes and interventions designed to address diabetic distress in this population.

Summary points
  • The prevalence and clinical significance of diabetes distress in adolescents with type 1 diabetes is not clear and information is sparse on effective interventions addressing diabetes distress in this patient group.
  • The study aimed to:
    1. Determine the prevalence of diabetes distress among adolescents with type 1 diabetes;
    2. Investigate the demographic, clinical, behavioral and psychosocial correlates of diabetes distress;
    3. Identify interventions targeting diabetes distress and determine common characteristics of successful interventions.
  • A search was performed for cross-sectional, observational or randomized controlled studies in which diabetes distress was assessed among adolescents with type 1 diabetes, and which were published in English after 1994.
  • Overall, 27 articles reporting on 16 studies were included in this review; participants’ ages ranged from 8 to 20 years.
  • With the exception of one study where the mean diabetes distress score was in the moderate range, on average, adolescents reported a low level of diabetes distress.
  • The proportion of patients experiencing severe diabetes distress was reported in three studies and ranged from 33% to 67%.

Hagger V et al. Curr Diab Rep 2016; 16: 9. doi: 10.1007/s11892-015-0694-2

Fear of hypoglycemia in children and adolescents and their parents with type 1 diabetes

This review provides a summary of the recent literature on fear of hypoglycemia in pediatric patients with type 1 diabetes.

Summary points
  • The term “fear of hypoglycemia” was coined to refer to the anxiety-like symptoms in individuals with diabetes or their families, which can manifest as worry about hypoglycemia and engagement in hypoglycemia avoidance behaviors, including overly vigilant blood glucose monitoring, maintaining elevated blood glucose levels by intentionally withholding insulin, and/or the premature or overtreatment of hypoglycemic events.
  • The prevalence of severe hypoglycemia, which is defined by seizure/loss of consciousness, in pediatric patients with type1 diabetes ranges from 5 to 12%.
  • Several questionnaires have been developed to assess fear of hypoglycemia in patients with type 1 diabetes, including hypoglycemia fear survey (HFS), HFS-II (both were developed for adults), HFS for parents (HFS-P), HFS for parents of young children (HFS-PYC), children’s hypoglycemia fear survey (HFS-C; a modification of HFS for 6 to 18 year-olds) and children’s hypoglycemia index (CHI).
  • Most studies fail to find a relationship between fear of hypoglycemia and glycemic control; the reasons for this are unclear.
  • All interventions addressing fear of hypoglycemia, such as cognitive behavioral therapy (individual or group), medical interventions and psychoeducation, have been designed for adults; however, these techniques can be used with children and adolescents with type 1 diabetes.
  • Several emerging technologies have the potential to reduce fear of hypoglycemia, including artificial pancreas, automated bolus calculators and continuous glucose monitoring.

Driscoll KA et al. Curr Diab Rep 2016; 16: 77. doi: 10.1007/s11892-016-0762-2

Contents

Back to collection

  1. Editorial
  2. Overview
  3. Adherence
  4. Diabetes distress and psychological comorbidities
  5. Disordered eating
  6. Quality of life
  7. Pyschosocial interventions
  8. Self management strategies

  9. Supplementary resource