In Type 1 Diabetes, Anxiety is Linked to Poor Self-Management

Because adolescents with type 1 diabetes have an increased risk for psychosocial comorbidities like anxiety, they may also have higher odds of poor self-management, according to new study findings presented at the American Diabetes Associations’ 78th Scientific Sessions.

For their study, Margaret Grey, DrPH, RN, FAAN, deputy director of the Yale Center for Clinical Investigation in New Haven, Connecticut, and colleagues interviewed adolescents with type 1 diabetes aged 10 to 16 from the Yale Program.
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Participants answered 10 open-ended questions. Demographic data, State-Trait Anxiety Inventory for Children (STAIC), and HbA_1c data were also assessed.

Among the patients included in the present analysis, mean hemoglobin A_1c (HbA_1c) was 8.3%, mean disease duration was 5.6 years, mean state anxiety was 47.1, and mean trait anxiety was 32.8.

Ultimately, results indicated that the added responsibility of type 1 diabetes took away from patients’ ability to fully participate in other aspects of their lives. The researchers noted that, although some participants were able to integrate the management of their condition into their daily lives, others were not able to do so.

Participants with anxiety frequently reported poor sleep quality, diabetes, other general lifestyle factors that were impacted by anxiety, or all of the above.

Further analyses of STAIC scores demonstrated adolescents with high levels of anxiety tended to be from single-parent families of lower economic status. In addition, all patients with high anxiety reported poor sleep and HbA_1c levels of at least 9.5%.

Compared with patients with high anxiety, those with low anxiety tended to be from families of higher socioeconomic status with 2 parents, and all had low HbA_1c levels of 7.5% of less and were still managed by their parents.

“Associations between anxiety symptoms and poorer self-management should be confirmed with further data,” the researchers concluded. “Increased screening and interventions for anxiety symptoms might be warranted.”

—Christina Vogt

Reference:

Rechenberg K, Sadler LS, Grey M. Anxiety in adolescents with type 1 diabetes. Diabetes. 2018;67(Supplement 1). https://doi.org/10.2337/db18-815-P