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Diabetes distress high in adolescents, particularly girls

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December 30, 2016

Girls with type 1 diabetes are nearly twice as likely as boys with the disease to exhibit moderate to severe diabetes distress, according to national survey data from Sweden.

Gun Forsander, MD, PhD, associate professor at the Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, and colleagues analyzed data from 453 adolescents with type 1 diabetes aged 15 to 18 years in the SWEDIABKIDS pediatric diabetes registry, who completed online questionnaires (mean age, 17 years; 66% girls; mean HbA1c, 7.7%; mean diabetes duration, 6.6 years). Respondents answered questions regarding psychological aspects of living with diabetes; selected items were used from the diabetes distress scale DDS-17, DDS-2, and the regimen-related distress subscale. Fear of hypoglycemia was assessed on a scale from 0 (“not at all”) to 10 (“very scared”). The survey sample was linked to diabetes information in the registry.

Young women scored higher on the DDS-2, as well as on all but one item on the diabetes regimen distress subscale (P < .0001). The greatest between-sex differences were observed for replies to the items “feeling overwhelmed by the demands of living with diabetes” and “not feeling motivated to keep up my diabetes self-management.”

Girls were also twice as likely to report moderate to severe diabetes distress vs. boys (44% vs. 19%), and girls’ scores on the fear of hypoglycemia scale were twice as high as boys (P < .0001), according to researchers. The mean HbA1c for girls was also higher vs. boys (P < .0001).

Researchers also found that sex was correlated with distress level even when controlling for lifestyle, social support, socioeconomic background and current diabetes education (P = .0003). Social support indicators were associated with diabetes distress levels for both boys and girls; boys and girls who reported talking with friends had lower distress scores (P < .0001).

“Our findings support that pediatric diabetes teams working with teenagers must intensify the care during this vulnerable period of life in order to reduce the risk of both psychological and vascular complications in young adults,” the researchers wrote. “This seems to be most important in females. Specific age- and gender-designed treatment regimens should be offered by professional diabetes teams to reduce the barriers and burdens for the young person living with diabetes.” – by Regina Schaffer

Disclosure: Novo Nordisk supported this study via a donation.