Depression in People with Type 1 Diabetes Linked to Poorer Health

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Madison Trimble
mtrimble@diabetes.org
703-549-1500 ext. 2139

Alexandria, Virginia
May 22, 2014

Children with Newly Diagnosed Type 1 and DKA Show Changes in Brain Function

People with type 1 diabetes who also suffer from depression don’t manage their diabetes as well as those who aren’t depressed, resulting in poorer clinical outcomes and sometimes serious consequences, such as more frequent episodes of severe hypoglycemia and diabetic ketoacidosis (DKA), according to a study being published in the June issue of Diabetes Care.

A separate study in the same issue found that children with newly diagnosed type 1 diabetes who developed DKA, a serious complication that occurs when the body produces high levels of blood acids called ketones, experienced persistent changes in brain function.

Depression and Type 1

Patients who scored higher on a test for depression had higher A1C levels, were more likely to miss insulin doses, exercised less often, checked blood glucose levels less frequently and experienced more frequent DKA and severe hypoglycemia than those who were not classified as depressed, reported researchers analyzing data from the T1D Exchange Clinic Registry.

“We’ve long known that people with type 2 diabetes who also show signs of depression experience greater morbidity and mortality and poorer glycemic control,” said lead author Paula Trief, PhD, State University of New York Upstate Medical University. “But not as much is known about how depression affects people with type 1 diabetes. What we found is that people with type 1 who also showed signs of depression experienced similar problems with their health, many of them potentially quite serious. Our findings strongly suggest that better identification and treatment of depression is needed for people with type 1.”

To reach lead author Paula Trief, email: triefp@upstate.edu

DKA and Brain Changes in Children with Type 1

A separate study, which looked at children newly diagnosed with type 1 diabetes at the Royal Children’s Hospital in Melbourne, Australia, found that those who exhibited DKA in the absence of diagnosed cerebral edema experienced temporary changes in white and gray brain matter volume in the frontal, temporal and parietal lobes that resolved within six months, but were associated with lasting problems with memory and attention.

“These early brain changes were associated with lower attention and memory six months later,” said lead author Fergus J. Cameron, MD, Head, Diabetes Services and Deputy Director, Department of Endocrinology and Diabetes and Centre for Hormone Research, Royal Children’s Hospital and Murdoch Children’s Research Institute. “Most importantly, we found these changes to be both frequent and persistent. Brain injury should no longer be considered a rare complication of DKA.”

The degree of acidosis and younger age appeared to be the greatest risk factors for children to experience alterations in cerebral structure and function, the authors found. They concluded that this evidence of brain injury was yet another imperative for earlier diagnosis of type 1 diabetes and prevention of DKA.

To reach lead author Dr. Fergus J. Cameron, email: Fergus.cameron@rch.org.au.

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