Type 1 diabetes

Diabetes stress negatively impacts HbA1c

Diabetes-related distress in adolescents is strongly related to HbA1c and also mediates an association between depressive symptoms and glycaemic control.

According to the latest findings from the Diabetes MILES Youth Study, more than a third (36%) of 13-19 year olds reported high levels of distress related to their diabetes.

This typically includes worry about their future and potential complications, feeling different from other teenagers, frustration that family and friends don’t understand what living with diabetes is like, and in girls, issues with weight and body image.

The study found teens with moderate or high levels of diabetes distress had higher levels of HbA1c than teens reporting no distress (8.3%; 67 mmol/mol v 7.5%; 58 mmol/mol).

About 21% of the 450 participating teenagers reported moderate to severe depressive symptoms.

However the study found the positive correlation between HbA1c and diabetes distress was stronger than that between HbA1c and depressive symptoms.

While diabetes duration and self-monitoring of blood glucose also correlated with elevate HbA1c, diabetes distress made the strongest independent contribution – explaining 18% of the variance in HbA1c.

Diabetes educator and registered nurse Virginia Hagger from the Australia Centre for Behavioral Research in Diabetes (ACBRD) told the limbic there was currently a big focus on measuring depression in young people.

“And this is not to diminish that at all because I think there are a lot of issues that increase as they reach adolescence such as depression but also anxiety, eating problems, etcetera.”

“But diabetes distress needs to be monitored too so we can have the conversation with young people about what we can do.”

Validated tools such as the Problem Areas in Diabetes – Teen version (PAID-T) were readily available, she said.

“Diabetes distress is a part of living with diabetes. You can expect people with diabetes to feel distressed at different times and maybe we should all become comfortable as health professionals talking to people about their distress.”

She said having those conversations with teenagers and keeping their parents engaged was important as was taking care in the way people speak about diabetes and blood glucose levels.

“We can talk about targets and actions rather than making a young person feel like they have failed if their blood sugar is too high.”

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