The impact of knowledge about diabetes, resilience and depression on glycemic control: a cross-sectional study among adolescents and young adults with type 1 diabetes

Abstract

BackgroundThe purpose of this study is to evaluate the relationship between glycemic control and the factors of knowledge about diabetes, resilience, depression and anxiety among Brazilian adolescents and young adults with type 1 diabetes.MethodsThis cross-sectional study included 85 adolescents and young adults with type 1 diabetes, aged between 11–22 years, with an average age of 17.7 ± 3.72 years. Glycemic control degree was evaluated through HbA1c. To assess psychosocial factors, the following questionnaires were used: resilience (Resilience Scale, RS) and anxiety and depression (Hospital Anxiety and Depression Scale, HADS). The Diabetes Knowledge Assessment Scale (DKNA) was used to assess knowledge about diabetes.ResultsSignificant correlations were found between HbA1c and resilience, anxiety and depression. Multiple linear regression analysis revealed that the only variable which presented significant association with the value of HbA1c was depression.ConclusionsDepression has a significant association with higher HbA1c levels, as demonstrated in a regression analysis. The results suggest that depression, anxiety and resilience should be considered in the design of a multidisciplinary approach to type 1 diabetes, as these factors were significantly correlated with glycemic control. Glycemic control was not correlated with knowledge of diabetes, suggesting that theoretical or practical understanding of this disease is not by itself significantly associated with appropriate glycemic control (HbA1c ≤ 7.5%).

Differences between patients with type 1 diabetes with optimal and suboptimal glycaemic control: A real‐world study of more than 30 000 patients in a US electronic health record database

“…We also found that a higher proportion of patients with suboptimal control had depression, although the conditions may have a reciprocal relationship. Previous studies among adolescents and young adults have postulated that depression can result in suboptimal glycaemic control. Meanwhile, suboptimal glycaemic control could be mediated, at least in part, by decreased self‐care behaviour in patients with a more depressive mood …”

The risk factors for postpartum depression: A population-based study

“…However, because diabetes and depression are highly correlated 21 with bidirectional causality, 22 it is possible that those with pre-gestational diabetes who have no history of depression represent a PPD resilient sub-group. 23,24 …”

“…Given that pregestational diabetes is generally considered to be a more serious and life-altering medical condition, this finding initially appears somewhat surprising. However, because diabetes and depression are highly correlated (Mezuk, Eaton, Albrecht, & Golden, 2008) with bidirectional causality (Pan, Lucas, & Sun, 2010), it is possible that those with pregestational diabetes who have no history of depression represent a PPD-resilient subgroup (Santos, Bernardo, & Gabbay, 2013;van Son, Nyklícek, & Pop, 2013).…”

Health‐related quality of life of adolescents with type 1 diabetes in the context of resilience

“…In Yi et al’s longitudinal study exploring adult patients with T1D and Type 2 diabetes (T2D), RS resources predicted GC in 1‐year interval, RS had positive effect on GC and diabetes‐related distress. Santos et al also found association between RS and GC in adolescents and young adults with T1D in their cross‐sectional study. Yi‐Frazier's study investigating adolescents with T1D also confirmed that higher level of RS was associated with better quality of life, favorable GC and lower distress.…”