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Functional Symptoms in Pediatric Disease pp 133–143Cite as

Functional and Psychosocial Ramifications of Type 1 Diabetes Mellitus in Pediatric Endocrinology

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Abstract

Type 1 diabetes mellitus is a common chronic medical disorder of childhood and adolescence that requires intensive day to day management. In addition to measuring dietary intake, children and adolescents with diabetes must test their blood sugar and administer insulin multiple times daily. They are also responsible for correcting high and low sugars. A comprehensive diabetes knowledge base and effective family communication and problem solving skills are necessary to optimize blood sugar control, so as to avoid both short- and long-term diabetes complications. Diabetes management requires a unique therapeutic alliance in which patients and their families manage diabetes, and their healthcare providers serve as mentors and consultants.

Although diabetes-related stresses in themselves can be overwhelming, these stresses are often complicated by patient-related psychosocial stressors such as anxiety, an eating disorder, or depression. In addition, family and larger system challenges such as marital discord and the presence of other family chronic disease or financial pressures may also interfere with optimal diabetes management. This can result in adherence issues, functional symptoms, or suboptimal diabetes control. To complicate matters further, psychosocial issues often can lead to suboptimal blood sugar control, which in itself, can cause psychosocial distress.

Since blood sugar control and psychosocial factors are so closely linked, it is imperative that a whole person approach be followed for optimal diabetes management. Diabetes issues, especially those related to regimen adherence, need to be evaluated from a psychosocial as well as medical perspective and interdisciplinary solutions should be offered. In addition, research suggests that successful diabetes management requires a collaborative approach by medical and mental health professionals familiar with type 1 diabetes and its treatment.

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References

  1. Karvonen M, Viik-Kajander M, Moltchanova E, Libman I, LaPorte R, Tuomilehto J. Incidence of childhood type 1 diabetes worldwide. Diabetes Mondiale (DiaMond) Project Group. Diabetes Care. 2000;23(10):1516–26.

    Article  CAS  PubMed  Google Scholar 

  2. International Diabetes Foundation (IDF). Diabetes in the young: a global perspective. Diabetes Atlas. 2009;3:2027–33.

    Google Scholar 

  3. Harjutsalo V, Podar T, Tuomilehto J. Cumulative incidence of type 1 diabetes in 10,168 siblings of Finnish young-onset type 1 diabetic patients. Diabetes. 2005;54(2):563–9.

    Article  CAS  PubMed  Google Scholar 

  4. The Diabetes Control and Complications Trial Research Group. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993;329(14):977–86.

    Article  Google Scholar 

  5. ISPAD Clinical Practice Consensus Guidelines (2009). Pediatr Diabetes. 2009(Suppl 12):10.

    Google Scholar 

  6. Northam EA, Lin A, Finch S, Werther GA, Cameron FJ. Psychosocial well-being and functional outcomes in youth with type 1 diabetes 12 years after disease onset. Diabetes Care. 2010;33(7):1430–7.

    Article  PubMed Central  PubMed  Google Scholar 

  7. de Wit M, Snoek FJ. Depressive symptoms and unmet psychological needs of Dutch youth with type 1 diabetes: results of a web‐survey. Pediatr Diabetes. 2011;12(3 Pt 1):172–6.

    Article  PubMed  Google Scholar 

  8. Streisand R, Swift E, Wickmark T, Chen R, Holmes CS. Pediatric parenting stress among parents of children with type 1 diabetes: the role of self-efficacy, responsibility, and fear. J Pediatr Psychol. 2005;30(6):513–21.

    Article  PubMed  Google Scholar 

  9. Jones JM, Lawson ML, Daneman D, Olmsted MP, Rodin G. Eating disorders in adolescent females with and without type 1 diabetes: a cross sectional study. BMJ. 2000;320(7249):1563–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Delamater AM. Quality of life in youths with diabetes. Diabetes Spectr. 2000;13:42.

    Google Scholar 

  11. La Greca AM, Swales T, Klemp S, Madigan S, Skyler J. Adolescents with diabetes: gender differences in psychosocial functioning and glycemic control. Child Health Care. 1995;24(1):61–78.

    Article  Google Scholar 

  12. Hood KK, Huestis S, Maher A, Butler D, Volkening L, Laffel LM. Depressive symptoms in children and adolescents with type 1 diabetes: association with diabetes-specific characteristics. Diabetes Care. 2006;29(6):1389–91.

    Article  PubMed  Google Scholar 

  13. Stewart SM, Rao U, Emslie GJ, Klein D, White PC. Depressive symptoms predict hospitalization for adolescents with type 1 diabetes mellitus. Pediatrics. 2005;115(5):1315–9.

    Article  PubMed  Google Scholar 

  14. Lawrence JM, Standiford DA, Loots B, Klingensmith GJ, Williams DE, Ruggiero A, Liese AD, Bell RA, Waitzfelder BE, McKeown RE. Prevalence and correlates of depressed mood among youth with diabetes: the SEARCH for Diabetes in Youth Study. Pediatrics. 2006;117(4):1348–58.

    Article  PubMed  Google Scholar 

  15. Presicci A, Lecce P, Ventura P, Margari F, Tafuri S, Margari L. Depressive and adjustment disorders—some questions about the differential diagnosis: case studies. Neuropsychiatr Dis Treat. 2010;6:473–81.

    CAS  PubMed Central  PubMed  Google Scholar 

  16. Littlefield CH, Craven JL, Rodin GM, Daneman D, Murray MA, Rydall AC. Relationship of self-efficacy and binging to adherence to diabetes regimen among adolescents. Diabetes Care. 1992;15(1):90–4.

    Article  CAS  PubMed  Google Scholar 

  17. Grey M, Whittemore R, Tamborlane W. Depression in type 1 diabetes in children: natural history and correlates. J Psychosom Res. 2002;53(4):907–11.

    Article  PubMed  Google Scholar 

  18. Worthington B. Diabetes management in young people—family matters. Social Work Today. 2008;8(5):18.

    Google Scholar 

  19. Beidel DC, Christ MG, Long PJ. Somatic complaints in anxious children. J Abnorm Child Psychol. 1991;19(6):659–70.

    Article  CAS  PubMed  Google Scholar 

  20. Goebel-Fabbri AE. Diabetes and eating disorders. J Diabetes Sci Technol. 2008;2(3):530–2.

    Article  PubMed Central  PubMed  Google Scholar 

  21. Barnard K, Thomas S, Royle P, Noyes K, Waugh N. Fear of hypoglycaemia in parents of young children with type 1 diabetes: a systematic review. BMC Pediatr. 2010;10:50.

    Article  PubMed Central  PubMed  Google Scholar 

  22. Lowes L, Lyne P. Chronic sorrow in parents of children with newly diagnosed diabetes: a review of the literature and discussion of the implications for nursing practice. J Adv Nurs. 2000;32(1):41–8.

    Article  CAS  PubMed  Google Scholar 

  23. Rolland JS, Williams JK. Toward a biopsychosocial model for 21st-century genetics. Fam Process. 2005;44(1):3–24.

    Article  PubMed  Google Scholar 

  24. Rolland JS, Walsh F. Facilitating family resilience with childhood illness and disability. Curr Opin Pediatr. 2006;18(5):527–38.

    Article  PubMed  Google Scholar 

  25. Anderson BJ, Vangsness L, Connell A, Butler D, Goebel-Fabbri A, Laffel LM. Family conflict, adherence and glycaemic control in youth with short duration type 1 diabetes. Diabet Med. 2002;19(8):635–42.

    Article  PubMed  Google Scholar 

  26. Anderson B. Family conflict and diabetes management in youth: clinical lessons from child development and diabetes research. Diabetes Spectr. 2004;17(1):22–6.

    Article  Google Scholar 

  27. Miller-Johnson S, Emery RE, Marvin RS, Clarke W, Lovinger R, Martin M. Parent-child relationships and the management of insulin-dependent diabetes mellitus. J Consult Clin Psychol. 1994;62(3):603–10.

    Article  CAS  PubMed  Google Scholar 

  28. George E, Iveson C, Ratner H. Problem to solution: brief therapy with individuals and families. London: BT Press; 1990.

    Google Scholar 

  29. Delamater AM, Jacobson AM, Anderson B, Cox D, Fisher L, Lustman P, Rubin R, Wysocki T, Psychosocial Therapies Working Group. Psychosocial Therapies in Diabetes: report of the Psychosocial Therapies Working Group. Diabetes Care. 2001;24(7):1286–92.

    Article  CAS  PubMed  Google Scholar 

  30. Kahana S, Drotar D, Frazier T. Meta-analysis of psychological interventions to promote adherence to treatment in pediatric chronic health conditions. J Pediatr Psychol. 2008;33(6):590–611.

    Article  PubMed  Google Scholar 

  31. Laffel LM, Vangsness L, Connell A, Goebel-Fabbri A, Butler D, Anderson BJ. Impact of ambulatory, family-focused teamwork intervention on glycemic control in youth with type 1 diabetes. J Pediatr. 2003;142(4):409–16.

    Article  PubMed  Google Scholar 

  32. Nansel TR, Iannotti RJ, Liu A. Clinic-integrated behavioral intervention for families of youth with type 1 diabetes: randomized clinical trial. Pediatrics. 2012;129(4):866–73.

    Article  Google Scholar 

  33. Wysocki T, Harris MA, Buckloh LM, Mertlich D, Lochrie AS, Taylor A, Sadler M, Mauras N, White NH. Effects of behavioral family systems therapy for diabetes on adolescents’ family relationships, treatment adherence, and metabolic control. J Pediatr Psychol. 2006;31(9):928–38.

    Article  PubMed  Google Scholar 

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Acknowledgments

This work was supported in part, by grants from BD and the HAPI Foundation.

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Authors and Affiliations

  1. Department of Pediatric Endocrinology, Morristown Medical Center, Goryeb Children’s Hospital, 100 Madison Avenue, Morristown, NJ, 07962, USA

    Nicole L. Pilek MSW

  2. Mount Sinai School of Medicine, Goryeb Children’s Hospital, Morristown, NJ, USA

    Harold S. Starkman MD

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  1. Nicole L. Pilek MSW
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  2. Harold S. Starkman MD
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Correspondence to Nicole L. Pilek MSW .

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Editors and Affiliations

  1. Department of Pediatrics, SUNY Upstate Medical University, Syracuse, New York, USA

    Ran D. Anbar

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Pilek, N.L., Starkman, H.S. (2014). Functional and Psychosocial Ramifications of Type 1 Diabetes Mellitus in Pediatric Endocrinology. In: Anbar, R. (eds) Functional Symptoms in Pediatric Disease. Springer, New York, NY. https://doi.org/10.1007/978-1-4899-8074-8_9

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  • DOI: https://doi.org/10.1007/978-1-4899-8074-8_9

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4899-8073-1

  • Online ISBN: 978-1-4899-8074-8

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