title: High prevalence of depressive symptoms in well-controlled adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion.
abstract: BACKGROUND
  Researchers report co-morbid depressive symptoms in children with poorly controlled type 1 diabetes (T1D). However, excellent diabetes control may be associated with emotional distress as well. The aim of this study was to evaluate the prevalence of depressive symptoms in T1D children with HbA1c <7.5% and ≥ 7.5% treated with insulin pump.
  
  
  METHODS
  A total of 372 children (186 girls) with a mean age of 14.2 ± 2.0 years and mean diabetes duration of 5.3 ± 3.5 years were included. All subjects were treated for T1D for a minimum of 1 year. Children filled out a Polish version of the Children's Depression Inventory (CDI) and answered questions in the Quality of Life Questionnaire. Statistical analysis was made using Student's t-test, Mann-Whitney U-test, Fisher's exact test and Spearman's rank correlation.
  
  
  RESULTS
  Eighteen per cent (31/177) of participants with HbA1c <7.5% and 21% (41/195) with HbA1c ≥ 7.5% reported depressive symptoms (CDI scores ≥ 13). Adolescents with HbA1c <7.5% and CDI ≥ 13 had higher total insulin dose (p = 0.039) and longer diabetes duration (p = 0.043) than subjects with CDI < 13. There was no difference in prevalence of depressive symptoms among patients with HbA1c ≥ 7.5% and HbA1c <7.5% (odds ratio [1.25 95% confidence interval (CI) 0.75-2.11], p = 0.432). In both groups, adolescents with CDI ≥ 13 had worse quality of life than those with CDI < 13 (p < 0.0001).
  
  
  CONCLUSIONS
  In both groups, one in five adolescents with either good or poor glycemic control had depressive symptoms compared with <7% in subjects without diabetes. Long-lasting T1D significantly increased the risk of depressive symptoms in well-controlled youth. Depressive symptoms strongly affected the quality of life regardless of diabetes control.
authors: Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland.
authors: Beata
authors: B
authors: Zduńczyk
authors: Joanna
authors: J
authors: Sendela
authors: Agnieszka
authors: A
authors: Szypowska
mesh_terms: D000293:Adolescent; D002648:Child; D015331:Cohort Studies; D017281:Cost of Illness; D003863:Depression / Q000453:epidemiology* / Q000517:prevention & control; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000188:drug therapy / Q000523:psychology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis; D006786:Hospitals, Urban; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control*; D007003:Hypoglycemia / Q000517:prevention & control*; D007004:Hypoglycemic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D055104:Infusions, Subcutaneous; D007328:Insulin / Q000008:administration & dosage* / Q000627:therapeutic use; D007332:Insulin Infusion Systems; D008297:Male; D010044:Outpatient Clinics, Hospital; D011044:Poland / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life
chemical_list: D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C517652:hemoglobin A1c protein, human
keywords: adolescent; depression; glycated haemoglobin; insulin pump; quality of life