Adolescents with type 1 diabetes (T1D) are at a high risk of psychosocial comorbidity, e.g., anxiety, depression, and eating disorders. Anxiety symptoms have been associated with poorer glycemic control. Anxiety symptoms have not been well studied in these youth. Our aim was to describe the experience of anxiety symptoms in adolescents with T1D, especially related to diabetes self-management and sleep patterns.

We used qualitative description, consisting of 10 open-ended questions, the State-Trait Anxiety Inventory for Children (STAIC), and Hemoglobin A1c (A1c). The analysis was guided by the principles of thematic analysis. Demographic data, A1c, and STAIC scores were used to stratify the qualitative data.

Adolescents with T1D (ages 10-16) were recruited from the Yale Program. Twenty-nine participants were interviewed. Participants were mean age 13.6+1.9 years, 32% minority, 31% lower socioeconomic status (SES), A1c 8.3+1.3%, mean disease duration 5.6+3.7 years, mean state anxiety 47.1+4.5, and mean trait anxiety 32.8+8.2.

Four themes and 7 sub-themes emerged. Participants reported that T1D was an extra layer of responsibility that took time away from their ability to participate fully in other aspects of their lives. Some participants were able to integrate diabetes management into their lives, while others were not. Participants noted that their experience of anxiety was associated with poor quality sleep, general lifestyle factors, diabetes, or all of these. Exploratory stratified analyses based on levels of STAIC findings revealed that: adolescents with high state anxiety were from lower SES single-parent families and all reported poor sleep and high A1c levels (≥9.5%); those with low state anxiety were from higher SES families with two parents, all had low A1c levels (≤7.5%), and all were still managed by their parents.

Associations between anxiety symptoms and poorer self-management should be confirmed with further data. Increased screening and interventions for anxiety symptoms might be warranted.


K. Rechenberg: None. L.S. Sadler: None. M. Grey: None.

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