Major Finding: Adolescents with type 1 diabetes and clinically significant symptoms of depression are more likely to have higher hemoglobin A1c values and to perform less frequent blood glucose monitoring than nondepressed adolescents with diabetes.
Data Source: Prospective 6-month study of 144 adolescents in a pediatric diabetes clinic.
Disclosures: The study was supported by a career development award to Dr. Hood. The authors reported that they had no conflicts of interest.
Depressive symptoms in adolescents with type 1 diabetes might be a marker for poor treatment compliance, a new report shows.
Adolescents with type 1 diabetes and clinically significant symptoms of depression were more likely than their nondepressed peers to have higher glycosylated hemoglobin A1c values, and to perform less frequent daily blood glucose monitoring (BGM), Meghan E. McGrady and Dr. Korey K. Hood wrote in the journal.
The most commonly reported depressive symptoms among the 144 teens in the study included ineffectiveness and negative mood. These symptoms, linked to both hemoglobin A1c levels at baseline and to BGM at baseline and at 6 months, might be targets for intervention, the authors wrote.
Ms. Grady and Dr. Hood, who are affiliated with the Cincinnati Children's Hospital Medical Center, looked at 144 patients, aged 13-18 years, who had been treated at the hospital's pediatric diabetes clinic. Most of the participants were white (87%), female (69%), and from households with two caregivers (76%). They were asked to fill out the 27-item Children's Depression Inventory (CDI), in which individual symptoms are rated on a scale of 0 (no symptoms) to 2 (distinct symptoms). Total scores of 13 or greater on the validated scale are deemed to be portents of clinically significant depression. The investigators correlated the symptoms scores with data on BGM frequency obtained from downloads of blood glucose meter data taken at the time of clinic visit, and with hemoglobin A1c values measured by a standard point-of-care analyzer.
At baseline, 33 patients (23%) had CDI scores of 13 or greater (mean score for all participants: 7.92 ± 7.14). The most frequently reported symptoms were ineffectiveness (mean score 0.38 ± 0.41), negative mood (0.34 ± 0.36), anhedonia (0.32 ± 0.30), neegative self-esteem (0.24 ± 0.30), and interpersonal problems (0.15 ± 0.23).
The study, which the authors called the “first to examine the responses on CDI subscales in adolescents with type 1, had several limitations. Depressive symptoms were self-reported, and it is difficult to generalize the results to other samples because of the sociodemographic characteristics of the adolescents studied. Future studies should examine depressive symptoms over time, they said.