ESPE Abstracts

Background: Living with type 1 diabetes especially in developing countries can feel overwhelming for parents and children because constant vigilance is required for proper care with inadequacy of resources.

Objectives and hypothesis: Our aim was to investigate the frequency of depressive symptoms in children and adolescents with type 1 diabetes and their association with demographic, diabetes-specific, and family-functioning risk factors.

Method: The study was conducted using Epidemiologic Studies Depression Scale. 86 (42 males and 44 females) patients with type 1 diabetes from Diabetes Clinic in Alexandria University Children’s Hospital, Egypt, have completed the questionnaire during 1 November to 31 December 2015. Their mean age was 11.14±3.02 (Range 5.8–16.2 year). Logistic regression models were used to detect the predictors of depression.

Result: In the current study 44 children (51.16%) had score >15 indicating depressive state. Children who had depression were found to have significant longer duration of diabetes (5.7±2.5 year), higher mean total daily insulin dose (1.3±0.44 unit/kg), HbA1c level (9.9±1.7) and were less frequently treated with basal bolus insulin regimen (29.6%); P<0.001. Univariate logistic regression model showed that older age (OR, 1.2; 95% CI, 1.2–1.39), achieving puberty (OR, 0.3; 95% CI, 0.1–0.7), lower socio-economic status (OR, 0.19; 95% CI, 0.04–0.95), having less educated mother (OR, 0.28; 95% CI, 0.08–0.96), not on basal bolus insulin regimen (OR, 5.3; 95% CI, 2.1–13.4), receiving <3 daily injections (OR, 1.2; 95% CI, 0.27–0.55), DKA admission (one (OR, 3.6; 95% CI, 1.19–11.06), two (OR, 5.1; 95% CI, 1.2–21.4), three times (OR, 11.3; 95% CI, 1.8–122.5) were independent predictors for depression. For each one unit increase in total daily insulin dose or in HbA1c the log odds of having depression increased 5.3 and 3.3 respectively; P<0.001. Multivariate logistic regression model adjusted for significant predictors in the univariate model showed that HgbA1c is the only significant predictor for depression with C statistics of 0.83.

Conclusion: Children and adolescents with type 1 diabetes have higher frequency of depressive symptoms in a developing country. Poor glycemic control is the most significant predictor for depression in these patients.