Research Supports Multidisciplinary Approach for Pediatric Diabetes Management

LEXINGTON, Kentucky (November 30, 2021) — Recently published research from the University of Kentucky College of Medicine and the UK HealthCare Barnstable Brown Diabetes Center found high rates of traumatic exposure and post-traumatic stress disorder (PTSD) symptoms in a group of pediatric patients with type 1 diabetes. Psychiatric factors are known to negatively affect glycemic control and self-management of diabetes in children and adolescents. However, not much is known about the influence of trauma exposure and PTSD on type 1 diabetes.

To learn more about those factors, the researchers focused on the relationship between trauma exposure, PTSD, anxiety, depression, and diabetes self-management. The study published in Diabetes Spectrum looked at 99 participants, ages 7 to 21. The participating patients all have type 1 diabetes and were seen in the endocrinology clinic at the Barnstable Brown Diabetes Center. In addition to assessing each patient’s hemoglobin A1C and diabetes self-management, each patient also underwent standardized psychiatric screening questionnaires during their clinic visits.

The study found that 66% of the participants had traumatic exposure, 39% of whom also had PTSD symptoms. Researchers found that the most common trauma exposure was an accident and traumatic medical stress. They also found that when compared to the goal of treatment as defined by the American Diabetes Association guidelines, only 11% of children with type 1 diabetes achieved glycemic goals and only 40% of participants measured blood glucose four times a day. day checked.

The study ultimately concluded that while trauma was common in young people with type 1 diabetes, neither trauma nor PTSD was associated with changes in self-management. However, they do believe that certain forms of anxiety and suicidal thoughts are linked to poor self-management and higher HbA1c.

Rishi Raj, MD, who is currently the director of the Department of Endocrinology, Diabetes, and Metabolism at Pikeville Medical Center, helped lead the study during his fellowship at the University of Kentucky.

“Psychiatric conditions such as trauma exposure, PTSD, depression, anxiety disorders and suicidal ideation are common in children with type 1 diabetes,” he said. “Our study provides additional support for the management of childhood diabetes by a multidisciplinary team of social workers, psychologists or psychiatrists for routine screening, managing underlying psychiatric conditions, and coordinating care with endocrinologists and other diabetes specialists.”

Raj says psychiatric disorders are often underdiagnosed and even less often addressed. He says certain psychiatric symptoms, including some symptoms of anxiety, are associated with less frequent blood glucose checks.

“Careful screening and treatment of underlying psychiatric disorders may help improve diabetes-related outcomes in pediatric patients with type 1 diabetes,” he said.

Rishi was joined for this study by several others in the UK, including Mai Nguyen; Alba Morales Pozzo, MD; Meghan Marsac, Ph.D.; Olga Vselvoshakaya, Ph.D.; and lead author Amy Lynn Meadows, MD

This project was supported by a Research Starter Grant from the Kentucky Children’s Hospital – Children’s Miracle Network Research Fund. Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under Award Number UL1TR001998. The content is the sole responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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