A diagnosis with type 1 diabetes (T1D) in childhood is associated with an increased risk of many different psychiatric disorders later in life, according to new data published in the journal Nature Mental Health.1 The authors said the findings emphasize the need to monitor and address the mental health needs of children with diabetes.
Around 30 million people in the United States have diagnosed diabetes, including over 300000 children with T1D.2 It is well known that people living with diabetes, including children, are at a higher risk for depression, stress, and anxiety.3 This is likely due to multiple factors, such as dealing with daily diabetes care. However, there has been little research done on if this is caused by living with the disease or if there are underlying biological mechanisms.
Key Takeaways
- Children diagnosed with type 1 diabetes (T1D) are at a higher risk of developing various psychiatric disorders later in life, including mood, anxiety, and behavioral disorders, as well as substance use disorders.
- The study analyzed data from over 4,500 children with T1D, matched with 10 counterparts each without T1D, and tracked the development of psychiatric disorders over a follow-up period of 10 to 24 years.
- The findings underscore the importance of monitoring and addressing the mental health needs of children with T1D. The study suggests that the mental health challenges faced by these individuals are likely due to the daily management of the disease rather than common biological mechanisms.
“We know that people diagnosed with type 1 diabetes can experience diabetes distress,” Benjamin Perry, an author on the study, said in a release.4 “This can include extreme frustration with blood sugars and feelings of isolation and can lead to burnout, hopelessness, and a feeling of lack of control. It’s little wonder, then, that they are at risk of compounding mental health problems, spanning into their adult lives.”
READ MORE: Slideshow: Innovation in Diabetes Technology Could Improve Disease Management
A team of investigators from the University of Cambridge and Aarhus University conducted a study to “address the limitations of existing research and take steps toward assessing potential causal pathways between childhood-onset T1D and psychiatric disorders.” Data for the study was gathered from the Czech nationwide register of all-cause hospitalizations, which includes records of main diagnosis, up to 5 additional diagnosis, and sociodemographic characteristics.
The study cohort included 4556 children aged 14 years or younger with T1D who were seen at a hospital between January 1994 and December 2007. Each patient was matched with 10 unique counterparts who had no T1D up to that point on sex, age, and discharge year and month. Of all the participants, the mean age was 8.66 years and 52.81% were male. The risk of developing 6 psychiatric diagnostic groups and 21 specific or closely related psychiatric disorders were assessed during a follow-up period ranging from 10 to 24 years.
Investigators found that patients with childhood T1D were more likely to develop substance use disorders, mood disorders, anxiety disorders, behavioral syndromes, as well as personality and behavioral disorders. However, patients with T1D were less likely to develop psychotic disorders. Children with T1D were at an increased risk for 12 of the 21 psychiatric disorders, including alcohol use disorders, eating disorders, specific personality disorders, depression, and other anxiety disorders.
Study limitations include that observational outcomes were measured using data from inpatient services, that approaches to address potential sources of bias had limits, that the number of events for certain outcomes was very small, and that patients with T1D were allowed to be used as matched counterparts of other people with T1D before they developed the disease.
“Although we found a concerning increase in the risk of mental health problems among people living with type 1 diabetes, our study—and others before it—suggest this is unlikely to be the result of common biological mechanisms,” Tomáš Formánek, lead author on the study, said in a release.4 “This emphasizes the importance of prevention and sustained attention to the mental health needs of children and young people with type 1 diabetes.”
READ MORE: Diabetes Resource Center
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References
1. Formánek T, Chen D, Šumník Z, et al. Childhood-onset type 1 diabetes and subsequent adult psychiatric disorders: a nationwide cohort and genome-wide Mendelian randomization study. Nat. Mental Health (2024). https://doi.org/10.1038/s44220-024-00280-8
