Study Finds Youth with Psychiatric Disorders More Likely to Underdose or Overdose Insulin


-Robin Lord

Diabetes-related stress issues can affect all those with type 1 diabetes, but it can especially hit hard for those in the early stages of life who are still trying to find their identities. Clinicians are increasingly advocating for more mental health screening as a necessary part of care for youth with type 1 diabetes.

Depression, anxiety, and disordered eating are all too common in teenagers and young adults with type 1 diabetes, and often are linked to more extreme blood sugar variability. For example, a recent study published in Pediatric Diabetes found that children with type 1 diabetes who practiced insulin manipulation (deliberately underdosing or overdosing insulin) were more than twice as likely to have psychiatric disorders than those children with type 1 diabetes who didn’t practice insulin manipulation. The most common of these psychiatric disorders was depression, followed by specific phobias, social phobia, and eating disorders.

Those youth with psychiatric disorders who practiced insulin manipulation also had higher rates of diabetic ketoacidosis (DKA) and hypoglycemia, according to the researchers from The Medical University of Vienna.

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Such findings strengthen the argument for increased mental health screenings for people with type 1 diabetes, according to Alicia McAuliffe-Fogarty, PhD, CPsychol, and VP of Patient Centered Research with T1D Exchange. Dr. McAuliffe-Fogarty collaborated with the American Diabetes Association on their 2016 position statement on psychosocial care for people with diabetes.

“Ideally, mental health providers should be embedded in diabetes care settings,” Dr. McAuliffe-Fogarty said.

Supporting a child or young adult with type 1 diabetes to develop strategies for dealing with feelings of sadness, hopelessness, or anxiousness can provide benefits throughout life, according to Dr. Mark Heyman, a diabetes psychologist and a Certified Diabetes Educator who is founder and director of the Center for Diabetes and Mental Health (CDMH).

“Even though the intersection of diabetes and mental health is complex, I want to assure that there’s hope,” Dr. Heyman said. “People can benefit from mental health treatment when they understand how their situation, emotion, or relationship is causing them to behave.”

In its 2016 position statement, The American Diabetes Association put out a list of recommendations to improve mental health support for people with diabetes, including that psychosocial care should be integrated into medical care for all people with diabetes.

To read the complete position statement, click here.

To read more about The Medical University of Vienna study, click here.  




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