In adolescents with diabetes, associations of depressive symptoms and diabetes distress (DD) with self-care behaviors and glycemic control vary considerably across studies, yet in adults, DD is a stronger predictor than depressive symptoms. This secondary data analysis compared the strength of the association of DD and depressive symptoms on bio-behavioral (HbA1c and average daily blood glucose monitoring checks [BGM]) and perceived global health among adolescents with diabetes.

Results: Data from 119 adolescents (75% T1D; diabetes duration of 4.8±4.5 years; HbA1c 8.7 ±2.3%; 62% female; mean age of 15.8±2.1 years; 36% Hispanic, 31% white) screened in clinic were analyzed. Teens completed the 2-item DD Scale (DDS2), the PHQ-9, and PROMIS Pediatric Global Health (PGH). Demographics, HbA1c, and BGM were obtained from medical chart review. Of the 119, 6% had severe depression (PHQ >10) and 22% had moderate to severe DD. DD was significantly correlated with HbA1c and BGM (r=.27, -.32;p=.004, .002; respectively); and both DD and PHQ were significantly correlated with the PGH (r=.43, -.57;ps<.001; respectively). In the regression models that included both DD and PHQ along with demographic and clinical covariates, DD was a significant predictor of HbA1c (ß= .31, partial r=.27, p=.004) and BGM (ß= -.24, partial r=-.23, p=.03). PHQ was not a significant predictor of either, but was a significant predictor of PGH (ß=-.6, partial r=-.47, p<.001). Type of diabetes was not a significant covariate.

Conclusion: DD had stronger associations with diabetes biobehavioral variables than depressive symptoms. Considering the outcomes are diabetes-specific, this is not surprising. However, it shows that simply screening for depression may miss an important aspect of the psychosocial health of adolescents with diabetes. Appropriate intervention should follow positive screens of DD to improve adolescents’ diabetes-related variables.


H. Abujaradeh: None. J.J. Wong: None. K.K. Hood: Consultant; Self; Lilly Diabetes. Research Support; Self; Dexcom, Inc. Speaker's Bureau; Self; Johnson & Johnson Diabetes Institute.

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