Anxiety in Children and Adolescents With Type 1 Diabetes

Abstract

Although anxiety is a normal and developmentally appropriate experience of childhood and anxiety disorders are among the most commonly diagnosed disorders, the prevalence of anxiety symptomatology and anxiety disorders in children with type 1 diabetes (T1D) is not well documented. Most studies have focused on anxiety-related syndromes associated with T1D including fear of hypoglycemia, specific phobia of needles (i.e., needle anxiety), and anxiety related to uptake of new and sophisticated diabetes technology (e.g., continuous glucose monitors, continuous subcutaneous infusion therapy), but the extant literature is sparse, and more research is greatly needed. Identification, prevention, and treatment of anxiety are critical to providing comprehensive diabetes care and management. This review provides a summary of the literature focused on anxiety in children and adolescents with T1D with suggestions for future research and clinical implications.

Adherence to insulin pump treatment declines with increasing age in adolescents with type 1 diabetes mellitus

“…Despite its potential impact on diabetes management, literature about needle anxiety in adolescents is scarce, having been mainly described in young children with type 1 diabetes . The univariate relation of fear of self‐testing to suboptimal diabetes management in our study confirms the findings of an earlier study .…”

“…The univariate relation of fear of self‐testing to suboptimal diabetes management in our study confirms the findings of an earlier study . The overall low total score on the fear of self‐testing questionnaire suggests that fear of self‐testing is rare in adolescents, however …”

ISPAD Clinical Practice Consensus Guidelines 2018: Assessment and management of hypoglycemia in children and adolescents with diabetes

“…This fear can induce anxiety and although in some cases, this anxiety can be adaptive, leading to appropriate vigilance in glucose management, in many individuals and their families, significant levels of anxiety can lead to disruptions in daily activities and suboptimal diabetes management . Given the negative consequences associated with hypoglycemic episodes, especially those that are severe in nature, it is not unforeseen that individuals with type 1 diabetes and their parents are at risk for increased anxiety, poor sleep and reduced quality of life . Fear of hypoglycemia, especially overnight, continues to be a major problem in the parents of young children with type 1 diabetes .…”

Adolescents with Diet-Related Chronic Health Conditions (DRCHCs) and Unique Risk for Development of Eating Pathology

“…For instance, individuals with T1D often experience mood difficulties and anxiety associated with their disorder, which may result in nonadherence [12,13]. GI symptoms have been positively correlated with distress, which has been associated with decreased health-related quality of life among those with IBD [14].…”