“Anxiety and Type 1 diabetes are like cousins”: The experience of anxiety symptoms in youth with Type 1 diabetes

Abstract

Type 1 diabetes (T1D) is one of the most common chronic health conditions in youth in the United States, and its incidence is rising worldwide. Youth with T1D are at a high risk of psychological comorbidity, for example, anxiety, depression, and eating disorders.Psychological comorbidities, especially anxiety symptoms, have been correlated with poorer diabetes outcomes, but anxiety symptoms have not been well studied in these youth. The primary aim of this study was to describe the experience of anxiety symptoms in youth with T1D, especially as those symptoms relate to diabetes selfmanagement tasks. We used a qualitative descriptive approach, consisting of an indepth, semi-structured interview comprising 10 open-ended questions with follow-up probes. The analysis was guided by the principles of thematic analysis. Demographic data, Hemoglobin A1c levels, and the State-Trait Anxiety Inventory for Children survey data were also collected and analyzed. We identified four themes and seven subthemes. Participants (n = 29, ages 10-16, 55% female) reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Some participants were dependent on parents and the school nurse for diabetes management. Participants described two types of anxiety symptoms, general and diabetes-specific, and they noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, and diabetes. K E Y W O R D S adolescence, anxiety, diabetes

Psychische Komorbiditäten bei Jugendlichen und jungen Erwachsenen mit Typ-1-Diabetes

“…Auch wenn noch nicht klar ist, ob ein bestimmtes Ausmaß an Angst, im Speziellen vor Hypoglykämien, und eine damit einhergehende erhöhte Wachsamkeit über den Glukosewert das Krankheitsmanagement verbessern kann, muss deutlich gemacht werden, dass Angst einen negativen Einfluss auf tägliche Aktivitäten haben kann. Rechenberg und Kollegen [74] befragten betroffene Jugendliche, wie Hypoglykämieangst sie im Alltag beeinflusst. Die Jugendlichen gaben an, die Öffentlichkeit zu meiden, um dort keine Hypoglykämien zu riskieren, und viele berichteten von ihrer Furcht, nachts zu sterben.…”

“…Sie könnten erst einschlafen, wenn sie den Eindruck hätten, dass ihr Glukosewert auf einem sicheren Niveau sei. Dies führt zu einer geringeren Schlafqualität [74].…”

Shape of Life: A Qualitative Study on the Challenges Posed by Diabetic Students

“…(Burns, 2017). Adequate self-management requires constant attention, including frequent blood glucose monitoring, regular insulin administration, and complicated daily decisionmaking (Rechenberg et al, 2018).…”

State and Trait Anxiety and Diabetes Outcomes in Youth With Type 1 Diabetes

“…[5][6][7] Self-management of the treatment regimen often interferes with the desire for independence and peer acceptance in youth and is a source of mental health comorbidity, including anxiety and depressive symptoms. [8][9][10][11][12] Adolescence is a transitional period that includes significant cognitive, psychosocial, and emotional changes in youth, regardless of health status. [13][14][15] It is the highest risk developmental period for the onset of mental health conditions, especially anxiety and depressive symptoms.…”

“…5-7 Self-management of the treatment regimen often interferes with the desire for independence and peer acceptance in youth and is a source of mental health comorbidity, including anxiety and depressive symptoms. 8-12…”