Background: Psychosocial factors may be fundamental explaining poor glycaemic control in children with type 1 diabetes (T1DM). Anxiety, depression are well described in children with T1DM. According to Kauffman (2012), diabetes management can only be successful if psychosocial needs are assessed and addressed.
Objective and hypotheses: To examine the association between glycaemic control and scores on two screening tools measuring psychosocial risk and emotional distress in an Irish cohort of children with T1DM.
Methods: The risk index for poor glycaemic control (RI-PCG) is the screening tool to assess psychosocial risk. According to Schwartz et al. (2014) cut-off scores for low, moderate and high risk for poor glycaemic control are 02, 3 and >3 respectively. The paediatric index of emotional distress (PI-ED) was used for emotional distress assessment.
Results: 34 children with T1DM (15 girls, 19 boys) aged 417 years (mean 12.24±3.8) are was analysed. 78.1% had a low score (02) on the RI-PGC, 6.3% had a moderate score (3), 15.6% had high scores (<3). There was a significant association between higher RI-PGC scores and higher HbA1c (r=0.33, P<0.05). The mean total PI-ED score was 10.59±6.2. Almost 10% of patients showed a high risk for emotional distress. Higher HbA1c values were not significantly correlated with higher PI-ED scores (P>0.05). There was a significant association between higher RI-PGC scores and higher levels of emotional distress (PI-ED scores) (r=0.42, P<0.05).
Conclusion: High psychosocial risk is associated with poor glycaemic control and emotional distress. Preliminary analyses suggest that screening tools for psychosocial risk and emotional distress (RI-PGC and PI-ED) may have utility in clinical practice. The ability to predict higher risk of diabetes related complications and psychological distress would allow for early intervention by trained clinical Psychologist. However, further prospective assessment of the predictive power of these screening tools is warranted.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology