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 Based on data for more than 1 million young people born in Quebec,
researchers found that being diagnosed with diabetes is associated
with increased odds of being diagnosed in an emergency room or
hospital with a mood disorder like depression. It's also linked to
higher odds of being admitted to a hospital for a suicide attempt,
according to the report in Diabetes Care.
Between the ages of 15 and 25, adolescents and young adults with
diabetes are 325% as likely to attempt suicide as their same-age
peers, and 133% as likely to suffer from a mood disorder, said Dr.
Marie-Eve Robinson, a pediatric endocrinologist at the Children's
Hospital of Eastern Ontario, in Ottawa, Canada, who led the study.
Past research has explored risks for psychiatric disorders in
individuals with and without type-1 diabetes, Robinson and her
colleagues write in Diabetes Care, but the risks during the
transition from adolescence to adulthood have not been assessed.
"In addition to challenges inherent to adolescence, young adults
with diabetes who transition to adult care need to adapt to a new
adult-care provider and a treatment facility," Robinson told Reuters
Health.
Young adults tend to perceive pediatricians as more family-centered
and less formal compared to adult-care providers and this can
sometimes make the transition difficult, she explained.
Type-1 diabetes, formerly known as juvenile diabetes, occurs when
the pancreas makes little or no insulin; the disease typically
emerges in childhood or adolescence. Type-2 diabetes, the more
common form of the illness, is associated with aging and overweight
and occurs when the body becomes less responsive to insulin.
Young people with type-1 diabetes must also take full responsibility
for managing their diabetes, Robinson said, which includes injecting
insulin multiple times a day, monitoring their glucose and paying
close attention to diet and physical activity.
"This can be overwhelming, especially when their previous caregivers
were providing significant support during childhood and
adolescence."
To assess the mental health toll of these burdens, the researchers
used Quebec registries to identify people born between April 1982
and December 1998 without any mental illness diagnosed before age
15. The final analysis included 3,544 adolescents diagnosed with
diabetes between ages 1 and 15, and nearly 1.4 million young people
without diabetes.
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The study team followed the youths from age 15 to 25 and found that
in addition to increased risks for a mood disorder diagnosis or a
suicide attempt, youth with diabetes were almost twice as likely to
visit a psychiatrist, compared to peers without diabetes.
With diabetes, young people also had a 29% higher risk of being
diagnosed with any psychiatric disorder. However, there were no
differences between the groups in schizophrenia diagnoses.
Even without a diagnosis of diabetes, there is a lot of anxiety and
depression nowadays in the adolescent population, said Dr.
Anastassios G. Pittas, co-director of the Diabetes and Lipid Center,
at Tufts Medical Center in Boston.
"To be diagnosed, on top of that, with a chronic, incurable medical
condition that affects essentially every minute of one's life has a
huge impact," Pittas, who was not involved in the current study,
told Reuters Health in a phone interview.
However, depending on the age of the child, a major medical
diagnosis need not always have a negative impact, he added.
For Pittas, one major limitation of the study was the large range in
ages at which diabetes was diagnosed, and he would have liked to see
if there were differences in mental health risk on that basis.
"Children diagnosed with diabetes at age 1 or 2 do not know life
without diabetes," said Pittas, adding that kids diagnosed before
ages 7 or 8 tend to do better than those diagnosed in the middle of
adolescence.
Even so, the study authors note in their report, endocrinologists
who treat young adults rarely receive a patient's psychosocial
summary as part of their referral documents from their pediatric
colleagues.
"As children with diabetes will inevitably transfer to adult care,
pediatric and adult healthcare providers should be aware of the
increased risk of developing mental health problems," Robinson said.
SOURCE: https://bit.ly/2uvRfH0 Diabetes Care, online December 16,
2019.
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