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Psychosocial Burden and Glycemic Control During the First Six Years of Diabetes: Results from the SEARCH for Diabetes in Youth Study
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10 2014
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Source: J Adolesc Health. 2014; 55(4):498-504
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Alternative Title:J Adolesc Health
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Description:Purpose
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.
Methods
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.
Results
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.
Conclusions
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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Pubmed ID:24815959
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Pubmed Central ID:PMC4497539
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