Type 1 diabetes mellitus (T1DM) is the most common type of diabetes in children. This study aimed to investigate psycho-behavioral changes in Chinese children with T1DM and to provide some advices for nurses, parents and other persons.
Forty-five patients with T1DM (26 boys and 19 girls with a mean age of 10.40±3.01 years) were enrolled. According to the glycosylated hemoglobin levels recommended by the American Diabetes Association, the patients were subdivided into a well-controlled group and a poorly-controlled group. Fifty-three healthy children served as a control group. Psycho-behavioral changes were investigated by using Achenbach’s Child Behavior Check List.
Compared with the control group, the patients with T1DM had significantly higher mean scores for withdrawal, anxiety/depression, attention problems, delinquent behavior, aggressive behavior, externalizing problems, and internalizing problems (P<0.017). Moreover, the mean scores for somatic complaints in the poorly-controlled subgroup were significantly higher than those in the well-controlled subgroup (t=3.582, P=0.001). Compared with the control group, the well-controlled subgroup had higher scores for withdrawal, anxiety/depression, and internalizing problems (P<0.017). But the poorly-controlled subgroup had higher scores for withdrawal, somatic complaint, anxiety/depression, delinquent behavior, aggressive behavior, externalizing and internalizing problems (P<0.017).
Children with T1DM may have some psycho-behavioral problems. Timely nursing interventions must be conducted to solve these problems.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
van Son J, Nyklicek I, Pop VJ, Blonk MC, Erdtsieck RJ, Spooren PF, et al. The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA(1c) in outpatients with diabetes (DiaMind): a randomized controlled trial. Diabetes Care 2013;36:823–830.
Li C, Ford ES, Zhao G, Balluz LS, Berry JT, Mokdad AH. Undertreatment of mental health problems in adults with diagnosed diabetes and serious psychological distress: the behavioral risk factor surveillance system, 2007. Diabetes Care 2010;33:1061–1064.
Garrison MM, Katon WJ, Richardson LP. The impact of psychiatric comorbidities on readmissions for diabetes in youth. Diabetes Care 2005;28:2150–2154.
Gaudieri PA, Chen R, Greer TF, Holmes CS. Cognitive function in children with type 1 diabetes: a meta-analysis. Diabetes Care 2008;31:1892–1897.
Lawrence JM, Standiford DA, Loots B, Klingensmith GJ, Williams DE, Ruggiero A, et al. Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth study. Pediatrics 2006;117:1348–1358.
Lerner JA, Inui TS, Trupin EW, Douglas E. Preschool behavior can predict future psychiatric disorders. J Am Acad Child Psychiatry 1985;24:42–48.
Mounir GM, Abolfotouh MA. Psychosocial characteristics of diabetic students at Sporting Students Hospital in Alexandria. J Egypt Public Health Assoc 2005;80:475–493.
Cameron FJ, Skinner TC, de Beaufort CE, Hoey H, Swift PG, Aanstoot H, et al. Are family factors universally related to metabolic outcomes in adolescents with type 1 diabetes? Diabet Med 2008;25:463–468.
Du JM, Zhuang HX, Chai JK, Liu GF, Wang Y, Guo WH. Psychological status of congenital microtia patients and relative influential factors: analysis of 410 cases. Zhonghua Yi Xue Za Zhi 2007;87:383–387. [In Chinese]
Silverstein J, Klingensmith G, Copeland K, Plotnick L, Kaufman F, Laffel L, et al. Care of children and adolescents with type 1 diabetes: a statement of the American Diabetes Association. Diabetes Care 2005;28:186–212.
Petty CR, Rosenbaum JF, Hirshfeld-Becker DR, Henin A, Hubley S, LaCasse S, et al. The child behavior checklist broadband scales predict subsequent psychopathology: a 5-year follow-up. J Anxiety Disord 2008;22:532–539.
Steinhausen HC, Winkler Metzke C, Meier M, Kannenberg R. Behavioral and emotional problems reported by parents for ages 6 to 17 in a Swiss epidemiological study. Eur Child Adolesc Psychiatry 1997;6:136–141.
Dahlquist G, Källén B; Swedish Childhood Diabetes Study Group. School performance in children with type 1 diabetes—a population-based register study. Diabetologia 2007;50:957–964.
McDonnell CM, Northam EA, Donath SM, Werther GA, Cameron FJ. Hyperglycemia and externalizing behavior in children with type 1 diabetes. Diabetes Care 2007;30:2211–2215.
Tan SM, Shafiee Z, Wu LL, Rizal AM, Rey JM. Factors associated with control of type I diabetes in Malaysian adolescents and young adults. Int J Psychiatry Med 2005;35:123–136.
Baudrant M, Allenet B, Le Tallec C, Grangeat M, Calop J. Educating diabetic children: integrating representations by children aged 7 to 11 and their parents. Pharm World Sci 2007;29:699–703.
Gellar LA, Schrader K, Nansel TR. Healthy eating practices: perceptions, facilitators, and barriers among youth with diabetes. Diabetes Educ 2007;33:671–679.
Wennick A, Hallström I. Swedish families’ lived experience when a child is first diagnosed as having insulin-dependent diabetes mellitus: An ongoing learning process. J Fam Nurs 2006;12:368–389.
Vanelli M, Corchia M, Iovane B, Gelmetti C, Mele A, La Cava S, et al. Outside-hospital assistance for children and adolescents with type 1 diabetes mellitus. Acta Biomed 2006;77:163–167.
Becker SP, Langberg JM. Sluggish cognitive tempo among young adolescents with ADHD: relations to mental health, academic, and social functioning. J Atten Disord 2012 Mar 21. [Epub ahead of print].
Becker SP, Luebbe AM, Greening L, Fite PJ, Stoppelbein L. A preliminary investigation of the relation between thyroid functioning and sluggish cognitive tempo in children. J Atten Disord 2012 Dec 26. [Epub ahead of print].
Becker SP, Luebbe AM, Fite PJ, Stoppelbein L, Greening L. Sluggish cognitive tempo in psychiatrically hospitalized children: factor structure and relations to internalizing symptoms, social problems, and observed behavioral dysregulation. J Abnorm Child Psychol 2013 Jan 29. [Epub ahead of print].
About this article
Cite this article
Zheng, XP., Chen, SH. Psycho-behavioral changes in children with type 1 diabetes mellitus. World J Pediatr 9, 261–265 (2013). https://doi.org/10.1007/s12519-013-0428-y
- Child Behavior Check List
- type 1 diabetes mellitus