News & Research

Prevalence and associations of psychological distress in young adults with type 1 diabetes, by A.L. Hislop and colleagues. Diabetic Med 25:91?96, 2008

What is the problem and what is known about it so far?

People with type 1 diabetes are more likely to have mental health problems, such as depression and anxiety. Depression and mental distress may make blood glucose control more difficult, although studies of this have been mixed. Little is known about how different aspects of living with diabetes, such as the type of insulin regimen used, the blood glucose monitoring schedule, and the frequency of serious hypoglycemia, may affect the mental health of young adults with type 1 diabetes.

Why did researchers do this particular study?

Researchers wanted to find out how common mental distress is among young adults with type 1 diabetes and to learn more about its relationship to various diabetes-related factors.

Who was studied?

Ninety-two young adults with type 1 diabetes participated in the study.

How was the study done?

All participants had their A1C measured and completed two psychological questionnaires, as well as a third questionnaire that asked about their insulin regimen, blood glucose testing schedule, and recent serious hypoglycemic episodes.

What did the researchers find?

About one-third of participants reported symptoms of depression, and about the same number reported feeling mental distress. Participants with depression symptoms had higher A1C results. Distress was more of a problem for those who used insulin pumps and those who had more frequent serious hypoglycemia.

What were the limitations of the study?

The study design let researchers find links between mental health and diabetes care, but not learn whether mental health affected diabetes control or vice versa. The study included only 18 people who used insulin pumps, so larger studies will need to confirm the link between distress and pump use. With no control group, the researchers could not compare participants? mental health results to those of the general population. The study used participant reports of mental health problems, which may not be accurate. And finally, giving potential participants the chance to opt out may have affected the study?s results. If people who were more troubled chose not to participate, the findings could be underestimated. Likewise, if those who were in better mental health chose not to participate, the findings could be overestimated.

What are the implications of the study?

Because so many young adults with type 1 diabetes have mental health problems, psychologists should be included on the diabetes care team for these patients. Until larger studies are done, health care providers should bear in mind that insulin pump use may not always improve the quality of life for young adult patients.

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