<scp>ISPAD Clinical Practice Consensus Guidelines</scp>
            2022: Psychological care of children, adolescents and young adults with diabetes

Gajewska, Katarzyna Anna; Goethals, Eveline R.; McDarby, Vincent; Zhao, Xiaolei; Hapunda, Given; Delamater, Alan M.; DiMeglio, Linda A.

doi:10.1111/pedi.13428

Cited by 37 publications

(54 citation statements)

References 270 publications

(619 reference statements)

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“…Assessment of the psychological, social, and emotional impact of diabetes in children and adolescents should be routinely included in daily clinical practice to detect needs and barriers to effective selfmanagement, as recommended by ISPAD and the International Society for Pediatric and Adolescent Diabetes Clinical Practice Consensus Guidelines [28,34,35].…”

Section: Discussionmentioning

confidence: 99%

Translation into Spanish and cross-cultural adaptation and validation of the Problem Areas in Diabetes – Pediatric version (PAID-Peds) survey: study protocol

Marsal

Monzón

Duce

et al. 2023

Preprint

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Background The metabolic and psychological management of pediatric type 1 diabetes mellitus (T1DM) can be challenging over time given that T1DM may cause a negative emotional burden and, consequently, result in poor metabolic control of the disease. The objectives of this study are to translate the Problem Area in Diabetes Survey–Pediatric version (PAID-Peds) into Spanish, adapt it culturally and validate it. Methods A multicenter, observational, prospective and analytical study based on a sample of 636 patients aged 8–17 years, diagnosed with T1DM, under treatment with insulin and follow-up at the Miguel Servet University Hospital in Zaragoza (Aragón, Spain), the Ramón y Cajal University Clinical Hospital in Madrid (Spain) and at the Sant Joan de Déu Hospital in Barcelona (Catalonia, Spain) between 1 January 2023 and 31 December 2024. The study will consist of two phases: 1) Translation and cultural adaptation of the original PAID-Peds® survey into Spanish following eight steps; 2) Validation of the Spanish version of the PAIS-Peds® survey. The statistical analysis will be performed using Jamovi® 2.1.23, the reliability or internal consistency will be calculated using Cronbach’s alpha index (considering an index higher than 0.8 to be good) and the test-retest will be evaluated using the intraclass correlation coefficient. This study has been approved by the ethics and research committees at each center. Discussion Detecting the burden of having diabetes could favor early interventions to reduce anxiety and prevent the worsening of distress, exhaustion, and depressive symptoms, and subsequent poor diabetes control. Therapeutic education in diabetes—recommended by the WHO and the Diabetes Education Study Group—has shown encouraging results in glycemia and psychosocial and behavioral factors in T1DM.

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Section: Discussionmentioning

confidence: 99%

Translation into Spanish and cross-cultural adaptation and validation of the Problem Areas in Diabetes – Pediatric version (PAID-Peds) survey: study protocol

Marsal

Monzón

Duce

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…Children and adolescents with T1D are at elevated risk of psychiatric disorders. [1][2][3][4][5] Most, if not all, psychiatric disorders pose challenges to diabetes management and adversely affect life-course outcomes. 6,7 Psychotropic medications are cost-effective and widely used for alleviating psychiatric and neurodevelopmental conditions, 8 such as depression, anxiety, and attention-deficit/hyperactivity disorder (ADHD).…”

Section: Introductionmentioning

confidence: 99%

“…Type 1 diabetes (T1D) is one of the most common chronic condition onsets during childhood. Children and adolescents with T1D are at elevated risk of psychiatric disorders . Most, if not all, psychiatric disorders pose challenges to diabetes management and adversely affect life-course outcomes …”

Section: Introductionmentioning

confidence: 99%

Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes

Liu,

Lagerberg,

Ludvigsson

et al. 2023

JAMA Netw Open

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ImportanceChildren and adolescents with type 1 diabetes (T1D) face elevated risks of psychiatric disorders. Despite their nonnegligible adverse effects, psychotropic medications are a common cost-effective approach to alleviating psychiatric symptoms, but evidence regarding their dispensation to children and adolescents with T1D remains lacking.ObjectiveTo examine the trends and patterns of psychotropic medication dispensation among children and adolescents with T1D in Sweden between 2006 and 2019.Design, Setting, and ParticipantsThis cohort study used data from multiple Swedish registers. The main study cohort included children and adolescents residing in Sweden from 2006 to 2019 and was followed up until the earliest of December 31, 2019, 18th birthday, emigration, or death. Data analyses were conducted from November 1, 2022, to April 30, 2023.ExposuresType 1 diabetes.Main Outcomes and MeasuresThe primary outcomes were trends and patterns of psychotropic medication dispensation (including antipsychotics, antidepressants, anxiolytics, hypnotics, mood stabilizers, and medications for attention-deficit/hyperactivity disorder [ADHD]), psychotropic medication initiation, and history of neurodevelopmental and psychiatric diagnosis. Cumulative incidence curves and Cox proportional hazard models were used to estimate the aggregated incidence and hazard ratios of medication initiation after diabetes onset.ResultsOf 3 723 745 children and adolescents (1 896 199 boys [50.9%]), 13 200 (0.4%; 7242 boys [54.9%]) had T1D (median [IQR] age at diagnosis, 11.1 [7.6-14.7] years). Between 2006 and 2019, psychotropic medication dispensation increased from 0.85% (95% CI, 0.65%-1.10%) to 3.84% (3.11%-4.69%) among children and from 2.72% (95% CI, 2.15%-3.39%) to 13.54% (95% CI, 12.88%-14.23%) among adolescents with T1D, consistently higher than their peers without T1D. The most commonly dispensed medications included hypnotics, ADHD medications, anxiolytics, and selective serotonin reuptake inhibitors, and all exhibited increasing trends. For those with T1D, psychiatric care was the primary prescription source, and up to 50.1% of treatments lasted more than 12 months. In addition, children and adolescents with T1D showed higher cumulative incidence and hazard ratios of medication initiation after diabetes onset than their same-age and same-sex counterparts.Conclusions and RelevanceThis cohort study found an increasing trend in psychotropic medication dispensation among children and adolescents with T1D from 2006 to 2019, persistently higher than those without T1D. These findings call for further in-depth investigations into the benefits and risks of psychotropic medications within this population and highlight the importance of integrating pediatric diabetes care and mental health care for early detection of psychological needs and careful monitoring of medication use.

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“…The psychosocial and behavioral challenges of living with type 1 diabetes (T1D) have been widely documented. The prevalence of diabetes distress (DD; an expected emotional response to the challenges of living with diabetes) has been estimated at 20-40% among people with T1D, who also have elevated risk for other mental health conditions [1,2]. Self-management of T1D is unremitting, comprising over 600 discrete tasks [3], and its time demands and interference with other life activities may contribute to DD and detract from quality of life (QoL) [4].…”

Section: Introductionmentioning

confidence: 99%

Integrating psychosocial and behavioral interventions into type 1 diabetes care

Pyatak,

Khurana

2023

Current Opinion in Endocrinology, Diabetes &Amp; Obesity

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Purpose of review To identify recent literature evaluating the efficacy of psychosocial and behavioral interventions for people with type 1 diabetes (T1D). Recent findings Interventions generally produce benefits for psychosocial and behavioral outcomes, and some also positively impact glycemia. Addressing psychosocial concerns during routine provider visits had mixed results; some studies found that structured tools improved well being, while others found they could derail conversations, or contribute to worsening glycemia due to a lack of time to review medical concerns. Integrating behavioral health providers in routine care, however, had a positive impact on glycemic outcomes. Stepped care interventions show promise for both children and adults, as they maximize available resources while contributing to improved well being. Group interventions, delivered either virtually or in-person, demonstrated benefits for diabetes distress, depressive symptoms, family conflict, and health behaviors, but had limited impact on positive parenting skills. Gaps in the current literature include limited research among adults and no research among older adults, as well as a lack of pragmatic research emphasizing implementation of effective interventions. Summary A wide range of interventions have demonstrated positive impacts on well being among people with T1D; more research is needed to identify strategies to routinely integrate psychosocial and behavioral support in clinical care.

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ISPAD Clinical Practice Consensus Guidelines 2022: Psychological care of children, adolescents and young adults with diabetes

Cited by 37 publications

References 270 publications

Translation into Spanish and cross-cultural adaptation and validation of the Problem Areas in Diabetes – Pediatric version (PAID-Peds) survey: study protocol

Translation into Spanish and cross-cultural adaptation and validation of the Problem Areas in Diabetes – Pediatric version (PAID-Peds) survey: study protocol

Psychotropic Medication Use in Children and Adolescents With Type 1 Diabetes

Integrating psychosocial and behavioral interventions into type 1 diabetes care

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