Current Diabetes Reports

, Volume 10, Issue 6, pp 436–443

Preventing Poor Psychological and Health Outcomes in Pediatric Type 1 Diabetes

Article

Abstract

Youth with type 1 diabetes are at high risk for psychosocial morbidities. These include depression, disturbed eating behavior, family conflict, poor health-related quality of life, low self-efficacy, and difficulty with medical adherence and metabolic control. A number of prevention interventions have been studied in this group, with the overall goal of improving adaptation and coping skills. This paper reviews the current research aimed at preventing poor outcomes in youth with type 1 diabetes and recommends simple interventions that can be added to clinical encounters. Recommendations for future psychosocial prevention studies are also discussed.

Keywords

Diabetes Prevention Psychosocial Depression Coping Family conflict Health-related quality of life Self-efficacy Adjustment 

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Institute of Medicine: The Future of the Public’s Health in the 21st Century. Washington D.C.: National Academy Press; 2002.Google Scholar
  2. 2.
    Evans D, Seligman M: Introduction In Treating and Preventing Adolescent Mental Health Disorders: What We Know and What We Don’t Know. Edited by Evans D, Foa E, Gur R, Hendin H, O’Brien C, Seligman M, Walsh T. Oxford: Oxford University Press; 2005:xxv–xi.CrossRefGoogle Scholar
  3. 3.
    Northam E, Matthews L, Anderson P, et al.: Psychiatric morbidity and health outcomes in type 1 diabetes: perspectives from a prospective longitudinal study. Diabet Med 2005, 22:152–157.CrossRefPubMedGoogle Scholar
  4. 4.
    Hood K, Peterson C, Rohan J, Drotar D: Association between adherence and glycemic control in pediatric type 1 diabetes: a meta-analysis. Pediatrics 2009, 124:1171–1179.CrossRefGoogle Scholar
  5. 5.
    Wysocki T, Harris M, Buckloh L, et al.: Self care autonomy and outcomes of intensive therapy or usual care in youth with type 1 diabetes. J Pediatr Psychol 2006, 31:1036–1045.CrossRefPubMedGoogle Scholar
  6. 6.
    Rewers A, Chase P, Mackenzie T, et al.: Predictors of acute complications in children with type 1 diabetes. JAMA 2002, 287:2511–2518.CrossRefPubMedGoogle Scholar
  7. 7.
    Leonard B, Jang Y, Savik K, et al.: Psychosocial factors associated with metabolic control in youth with type 1 diabetes. J Pediatr Nurs 2002, 7:28–37.CrossRefGoogle Scholar
  8. 8.
    Hassan K, Loar R, Anderson B, Heptuall R: The role of socioeconomic status, depression, quality of life and glycemic control in type 1 diabetes mellitus. J Pediatr 2006, 149:526–531.CrossRefPubMedGoogle Scholar
  9. 9.
    Bryden KS, Dunger DB, Mayou RA, et al.: Poor prognosis of young adults with type 1 diabetes: a longitudinal study. Diabetes Care 2003, 26:1052–1057.CrossRefPubMedGoogle Scholar
  10. 10.
    Cohen D, Lumley M, Naar-King S, et al.: Child behavior problems and family functioning as predictors of adherence and glycemic control in economically disadvantaged children with type 1 diabetes. J Pediatr Psychol 2004, 29:171–184.CrossRefPubMedGoogle Scholar
  11. 11.
    Hoey H, Aastoot H, Chiarelli F, et al.: Good metabolic control is associated with better quality of life in 2,101 adolescents with type 1 diabetes. Diabetes Care 2001, 24:1923–1928.CrossRefPubMedGoogle Scholar
  12. 12.
    Stewart S, Rao U, Emslie G, et al.: Depressive symptoms predict hospitalization for adolescents with type 1 diabetes mellitus. Pediatrics 2005, 115:1315–1319.CrossRefPubMedGoogle Scholar
  13. 13.
    Seiffge-Krenke I, Stemmler M: Coping with everyday stress and links to medical and psychosocial adaptation in diabetic adolescents. J Adolesc Health 2003, 33:180–188.CrossRefPubMedGoogle Scholar
  14. 14.
    Svoren B, Butler D, Levine B, et al.: Reducing acute adverse outcomes in youth with type 1 diabetes: a randomized control trial. Pediatrics 2003, 112: 914–922.CrossRefPubMedGoogle Scholar
  15. 15.
    Grey M, Whittemore R, Tamborlane W: Depression in type 1 diabetes in children: natural history and correlates. J Psychosom Res 2002, 53:907–911.CrossRefPubMedGoogle Scholar
  16. 16.
    Hood K, Huestis S, Maher A, et al.: Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care 2006, 29:1389–1391.CrossRefPubMedGoogle Scholar
  17. 17.
    McGrady M, Laffel L, Drotar D, et al.: Depressive symptoms and glycemic control in adolescents with type 1 diabetes: mediational role of blood glucose monitoring. Diabetes Care 2009, 32:804–806.CrossRefPubMedGoogle Scholar
  18. 18.
    Costello E, Mustillo S, Erkanli A, et al.: Prevalence and development of psychiatric disorders in childhood and adolescence. Arch Gen Psychiatry 2003, 60:837–844.CrossRefPubMedGoogle Scholar
  19. 19.
    Helgeson V, Siminerio L, Escobar O, Becker D: Predictors of metabolic control among adolescents with diabetes: a four year longitudinal study. J Pediatr Psychol 2009, 34:254–270.CrossRefPubMedGoogle Scholar
  20. 20.
    Lawrence J, Standiford D, Loots B: Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth Study. Pediatrics 2006, 117:1348–1358.CrossRefPubMedGoogle Scholar
  21. 21.
    Glasgow AM, Weissberg-Benchell JA, Tynan WD, et al.: Readmissions of children with diabetes mellitus to a children’s hospital. Pediatrics 1991, 88:98–104.PubMedGoogle Scholar
  22. 22.
    Garrison M, Katon W, Richardson L: The impact of psychiatric comorbidities on readmissions for diabetes in youth. Diabetes Care 2005, 28:2150–2154.CrossRefPubMedGoogle Scholar
  23. 23.
    Duke D, Geffken G, Lewin A, et al.: Glycemic control in youth with type 1 diabetes: family predictors and mediators. J Pediatr Psychol 2008, 33:719–727.CrossRefPubMedGoogle Scholar
  24. 24.
    Jones JM, Lawson ML, Daneman D, et al.: Eating disorders in adolescent females with and without type 1 diabetes: cross-sectional study. BMJ 2000, 320:1563–1566.CrossRefPubMedGoogle Scholar
  25. 25.
    Peveler RC, Bryden KS, Neil AW, et al.: The relationship of disordered eating habits and attitudes to clinical outcomes in young adult females with type 1 diabetes. Diabetes Care 2005, 28:84–88.CrossRefPubMedGoogle Scholar
  26. 26.
    Olmsted MP, Colton PA, Daneman, D, et al.: Prediction of the onset of disturbed eating behavior in adolescent girls with type 1 diabetes. Diabetes Care 2008, 31:1978–1982.CrossRefPubMedGoogle Scholar
  27. 27.
    Stice E, Marti CN, Shaw H, Jaconis M: An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents. J Abnorm Psychol 2009, 18:587–597.CrossRefGoogle Scholar
  28. 28.
    Gadalla T, Piran N: Psychiatric comorbidity in women with disordered eating behavior: a national study. Women Health 2008, 48:467–484.CrossRefPubMedGoogle Scholar
  29. 29.
    Rydall AC, Rodin GM, Olmsted MP, et al.: Disordered eating behavior and microvascular complications in young women with insulin-dependent diabetes mellitus. N Engl J Med 1997, 336:1849–1854.CrossRefPubMedGoogle Scholar
  30. 30.
    Goebel-Fabbri AE, Fikkan J, Franko DL, et al.: Insulin restriction and associated morbidity and motality in women with type 1 diabetes. Diabetes Care 2008, 31:415–419.CrossRefPubMedGoogle Scholar
  31. 31.
    Olmsted MP, Daneman D, Rydall AC, et al.: The effects of psychoeducation on disturbed eating attitudes and behavior in young women with type 1 diabetes mellitus. Int J Eat Disord 2002, 32:230–239.CrossRefPubMedGoogle Scholar
  32. 32.
    Stice E, Shaw H, Marti N: A meta-analytic review of eating disorder prevention programs: encouraging findings. Annu Rev Clin Psychol 2007, 3:207–231.CrossRefPubMedGoogle Scholar
  33. 33.
    Anderson B, Vangness L, Connell A, et al.: Family conflict, adherence, and glycaemic control in youth with short duration Type 1 diabetes. Diabet Med 2002, 19:635–642.CrossRefPubMedGoogle Scholar
  34. 34.
    Ellis D, Templin TN, Naar-King S, Frey MA: Toward conceptual clarity in a critical parenting construct: parental monitoring in youth with chronic illness. J Pediatr Psychol 2008, 33:799–808.CrossRefPubMedGoogle Scholar
  35. 35.
    Weibe D, Berg CA, Korbel C, et al.: Children’s appraisals of maternal involvement in coping with diabetes: enhancing our understanding of adherence, metabolic control, and quality of life across adolescence. J Pediatr Psychol 2005, 30:167–178.CrossRefGoogle Scholar
  36. 36.
    Wysocki T, Nansel T, Holmbeck G, et al.: Collaborative involvement of primary and secondary caregivers: associations with youth’s diabetes outcomes. J Pediatr Psychol 2009, 34:869–881.CrossRefPubMedGoogle Scholar
  37. 37.
    Weissberg-Benchell J, Nansel T, Holmbeck G, et al.: Generic versus diabetes-specific quality of life and parent-child behaviors among youth with type 1 diabetes. J Pediatr Psychol 2009, 34:977–988.CrossRefPubMedGoogle Scholar
  38. 38.
    Nansel T, Rovner A, Haynie D, et al.: Development and validation of the collaborative parent involvement scale for youth with type 1 diabetes. J Pediatr Psychol 2009, 34:30–40.CrossRefPubMedGoogle Scholar
  39. 39.
    Anderson B, Brackett J, Ho J, Laffel L: An office-based intervention to maintain parent-adolescent teamwork in diabetes management: impact on parent involvement, family conflict, and subsequent glycemic control. Diabetes Care 1999, 22:713–721.CrossRefPubMedGoogle Scholar
  40. 40.
    Laffel LM, Vangsness L, Connell A, et al.: Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr 2003, 142:409–416.CrossRefPubMedGoogle Scholar
  41. 41.
    Spieth LE, Harris CV: Assessment of health-related quality of life in children and adolescents: an integrative review. J Pediatr Psychol 1996, 21:175–193.CrossRefPubMedGoogle Scholar
  42. 42.
    Cella D: Quality of life outcomes: measurement and validation. Oncology (Williston Park) 1996, 10(11 Suppl):233–246Google Scholar
  43. 43.
    Varni JW, Seid M, Kurtin PS: PedsQL 4.0: reliability and validity of the Pediatric Quality of Life Inventory version 4.0 generic core scales in healthy and patient populations. Med Care 2001, 39:800–812.CrossRefPubMedGoogle Scholar
  44. 44.
    Seid M, Varni JW, Rode CA, Katz ER: The Pediatric Cancer Quality of Life Inventory: a modular approach to measuring health-related quality of life in children with cancer. Int J Cancer Suppl 1999, 12:71–76.CrossRefPubMedGoogle Scholar
  45. 45.
    Silverstein J, Klingensmith G, Copeland K, et al.: Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005, 28:186–212.CrossRefPubMedGoogle Scholar
  46. 46.
    • de Wit M, Delemarre-van de Waal H, Bokma JA, et al.: Monitoring and discussing health-related quality of life in adolescents with type 1 diabetes improve psychosocial well-being: a randomized controlled trial. Diabetes Care 2008, 31:1521–1526. HRQoL in adolescents was assessed during clinic visits and then discussed with the medical team. At 1-year follow-up, teens showed fewer behavioral problems, improved self-esteem, more participation in family activities, and were more satisfied with their medical care. Google Scholar
  47. 47.
    de Wit M, Delemarre-van de Waal H, Bokma JA, et al.: Follow-up results on monitoring and discussing health-related quality of life in adolescent diabetes care: benefits do not sustain in routine practice. Pediatr Diabetes 2010, 11:175–181.CrossRefPubMedGoogle Scholar
  48. 48.
    Graue M, Wentzel-Larsen T, Hanestad BR, Sovik O: Evaluation of a programme of group visits and computer-assisted consultations in the treatment of adolescents with type 1 diabetes. Diabet Med 2005, 22:1522–1529.CrossRefPubMedGoogle Scholar
  49. 49.
    • Channon SJ, Huws-Thomas MV, Rollnick S, et al.: A multicenter randomized controlled trial of motivational interviewing in teenagers with diabetes. Diabetes Care 2007, 30:1390–1395. Teens participating in a motivational interviewing intervention showed lower HbA 1c levels at the end of the 12-month intervention, and this was maintained for 1 year afterward. In addition, the intervention group had improved life satisfaction, lower life worry, less anxiety, and increased positive well-being. After the 12-month follow-up period, many of these differences persisted.Google Scholar
  50. 50.
    De Wit M, Snoek FJ: The DAWN MIND Youth program. Pediatr Diabetes 2009, 10 (Suppl 13):46–49.CrossRefPubMedGoogle Scholar
  51. 51.
    Davidson M, Boland EA, Grey M: Teaching teens to cope: coping skills training for adolescents with insulin-dependent diabetes mellitus. J Soc Pediatr Nurs 1997, 2:65–72.CrossRefPubMedGoogle Scholar
  52. 52.
    Grey M, Boland EA, Davidson M, et al.: Coping skills training for youth with diabetes mellitus has long-lasting effects on metabolic control and quality of life. J Pediatr 2000, 137:107–113.CrossRefPubMedGoogle Scholar
  53. 53.
    • Grey M, Whittemore R, Jaser S, et al.: Effects of coping skills training in school-age children with type 1 diabetes. Res Nurs Health 2009, 32:405–418. CST was offered in six weekly sessions to a group of 8- to 12-year-old children with type 1 diabetes and their parents. This study is especially important because it looks at school-age children, whereas most type 1 diabetes prevention studies enroll adolescents, and because it also included parents. This study suggests that family-based group programs are feasible and important for long-term adaptation and coping.Google Scholar
  54. 54.
    Franklin VL, Waller A, Pagliari C, Greene SA: A randomized controlled trial of Sweet Talk, a text-messaging system to support young people with diabetes. Diabet Med 2006, 23:1332–1338.CrossRefPubMedGoogle Scholar
  55. 55.
    Howells L, Wilson AC, Skinner TC, et al.: A randomized control trial of the effect of negotiated telephone support on glycaemic control in young people with type 1 diabetes. Diabet Med 2002, 19:643–648.CrossRefPubMedGoogle Scholar
  56. 56.
    Galatzer A, Amir S, Gil R, et al.: Crisis intervention program in newly diagnosed diabetic children. Diabetes Care 1982, 5:414–419.CrossRefPubMedGoogle Scholar
  57. 57.
    Hains AA, Berlin KS, Davies WH, et al.: Attributions of adolescents with type 1 diabetes related to performing diabetes care around friends and peers: the moderating role of friend support. J Pediatr Psychol 2007, 32:561–570.CrossRefPubMedGoogle Scholar
  58. 58.
    Greco P, Pendley JS, McDonell K, Reeves G: A peer group intervention for adolescents with type 1 diabetes and their best friends. J Pediatr Psychol 2001, 26:485–490.CrossRefPubMedGoogle Scholar
  59. 59.
    American Diabetes Association: Economic costs of diabetes in the U.S. in 2007. Diabetes Care 2008, 31:596–615.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Northwestern University, Feinberg School of Medicine, Children’s Memorial HospitalChicagoUSA
  2. 2.Children’s Memorial HospitalChicagoUSA

Personalised recommendations