Psychosocial Burden and Glycemic Control During the First Six Years of Diabetes: Results from the SEARCH for Diabetes in Youth Study
Published Date:May 10 2014
Source:J Adolesc Health. 2014; 55(4):498-504.
Corporate Authors:SEARCH for Diabetes in Youth Study Group
Pubmed Central ID:PMC4497539
Funding:00097/PHS HHS/United States
1UL1RR026314-01/RR/NCRR NIH HHS/United States
DP-05-069/DP/NCCDPHP CDC HHS/United States
DP-10-001/DP/NCCDPHP CDC HHS/United States
M01 RR00069/RR/NCRR NIH HHS/United States
M01RR00037/RR/NCRR NIH HHS/United States
P30 DK057516/DK/NIDDK NIH HHS/United States
P30 DK57516/DK/NIDDK NIH HHS/United States
U01 DP000244/DP/NCCDPHP CDC HHS/United States
U01 DP000245/DP/NCCDPHP CDC HHS/United States
U01 DP000246/DP/NCCDPHP CDC HHS/United States
U01 DP000247/DP/NCCDPHP CDC HHS/United States
U01 DP000248/DP/NCCDPHP CDC HHS/United States
U01 DP000250/DP/NCCDPHP CDC HHS/United States
U18 DP002710/DP/NCCDPHP CDC HHS/United States
U18 DP002714/DP/NCCDPHP CDC HHS/United States
U18 DP003256/DP/NCCDPHP CDC HHS/United States
UL1 RR029882/RR/NCRR NIH HHS/United States
UL1 TR000077/TR/NCATS NIH HHS/United States
UL1 TR000154/TR/NCATS NIH HHS/United States
UL1 TR000423/TR/NCATS NIH HHS/United States
UL1RR029882/RR/NCRR NIH HHS/United States
To evaluate the psychosocial burden of adolescents with diabetes, determine the trajectory of psychosocial burden, and examine the interdependent relationships between psychosocial burden and glycemic control across the first six years of diabetes.
Data from SEARCH for Diabetes in Youth, an observational study of U.S. children diagnosed with diabetes before age 20 years, were collected during study visits conducted at baseline and then 12, 24, and 60 months after baseline. Blood was drawn, clinical and demographic information was collected, and psychosocial burden was evaluated using standardized depression and generic and diabetes-specific health-related quality of life (QOL) surveys.
Among the 1,307 adolescents (mean age 14.1±2.5 years) with baseline data, 1,026 had type 1 diabetes and 281 had type 2 diabetes. For those with a 60-month follow-up visit, A1c values rose 1.5% from baseline (type 1 - 7.7% to 9.3%; type 2 - 7.3% to 8.8%). Adolescents with type 2 diabetes reported more depression and poorer QOL than adolescents with type 1 diabetes. For each diabetes type, there were similar baseline risk factors for higher A1c values; longer diabetes duration, ethnic minority status, and declining diabetes QOL (p<0.05). However, youth with type 2 had higher A1c values with increasing generic QOL, an unexpected finding. Younger adolescents with type 1 diabetes had higher A1c values at study's end.
Significant deterioration in glycemic control marks the first six years of diabetes for adolescents. Psychosocial burden, particularly poor diabetes-specific QOL, is a contributor to suboptimal glycemic outcomes.
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