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Type 1 Diabetes And Anxiety Disorders

Mental Health Issues In Adolescents And Young Adults With Type 1 Diabetes

Mental Health Issues In Adolescents And Young Adults With Type 1 Diabetes

Mental health comorbidities can negatively affect disease management in adolescents with chronic illnesses. This study sought to determine the prevalence and impact of mental health issues in a population of adolescents and young adults with type 1 diabetes. A cross-sectional study of 150 patients aged 11 to 25 years with type 1 diabetes from an urban, academic diabetes center was conducted. Participants completed 3 validated mental health disorder screening instruments: Beck’s Depression Inventory, the Screen for Child Anxiety Related Emotional Disorders-41 anxiety screen, and the Eating Disorder Screen for Primary Care. More than a third screened positive: 11.3% for depression, 21.3% for anxiety, and 20.7% for disordered eating (14.7% had ≥2 positive screens). Patients with a positive screen had twice the odds of having poor glycemic control as those without, as measured by HgbA1c. This study supports screening for mental health issues in adolescents and young adults with type 1 diabetes. Continue reading >>

Diabetes Is Associated With Anxiety Symptoms

Diabetes Is Associated With Anxiety Symptoms

Research shows that moderate-to-severe anxiety symptoms, an indication of a potential anxiety disorder, affect one in five people with insulin-treated type 2 diabetes and one in six with type 1 diabetes or non-insulin treated type 2 diabetes. Dr Adriana Ventura, Research Fellow at the Australian Centre for Behavioural Research in Diabetes (ACBRD) and registered psychologist, who conducted the study, says the prevalence of elevated anxiety symptoms and disorders in people with diabetes is within the range of general population estimates. However, having anxiety and diabetes poses additional challenges. “Living with diabetes can be difficult enough, managing healthy living, medications and monitoring, and fitting these into daily life. Experiencing anxiety as well adds to the burden, and can impact on both their medical outcomes and quality of life,” said Dr Ventura. Detecting anxiety among people with diabetes can be difficult, as some of the symptoms share similar physical symptoms to hypoglycaemia (high blood glucose levels). The relationship between diabetes and anxiety disorders needs to be further explored. For some people, diabetes may be completely unrelated to their anxiety – they just coexist – while for others, it may be that living with diabetes leads to feelings of anxiety. In response to the research, a resource from the National Diabetes Services Scheme (NDSS) highlights the impact of anxiety on diabetes management, and how to identify elevated anxiety symptoms. The resource, which was developed by the ACBRD in collaboration with Diabetes Australia, is titled: Diabetes and emotional health: A handbook for health professionals supporting adults with type 1 or type 2 diabetes. Dr Christel Hendrieckx, Senior Research Fellow and a clinical psychologist Continue reading >>

Anxiety And Depressive Symptoms As Predictors Of All-cause Mortality Among People With Insulin-naïve Type 2 Diabetes: 17-year Follow-up Of The Second Nord-trøndelag Health Survey (hunt2), Norway

Anxiety And Depressive Symptoms As Predictors Of All-cause Mortality Among People With Insulin-naïve Type 2 Diabetes: 17-year Follow-up Of The Second Nord-trøndelag Health Survey (hunt2), Norway

Abstract To examine whether elevated anxiety and/or depressive symptoms are related to all-cause mortality in people with Type 2 diabetes, not using insulin. 948 participants in the community-wide Nord-Trøndelag Health Survey conducted during 1995–97 completed the Hospital Anxiety and Depression Scale with subscales of anxiety (HADS-A) and depression (HADS-D). Elevated symptoms were defined as HADS-A or HADS-D ≥8. Participants with type 2 diabetes, not using insulin, were followed until November 21, 2012 or death. Cox regression analyses were used to estimate associations between baseline elevated anxiety symptoms, elevated depressive symptoms and mortality, adjusting for sociodemographic factors, HbA1c, cardiovascular disease and microvascular complications. At baseline, 8% (n = 77/948) reported elevated anxiety symptoms, 9% (n = 87/948) elevated depressive symptoms and 10% (n = 93/948) reported both. After a mean follow-up of 12 years (SD 5.1, range 0–17), 541 participants (57%) had died. Participants with elevated anxiety symptoms only had a decreased mortality risk (unadjusted HR 0.66, 95% CI 0.46–0.96). Adjustment for HbA1c attenuated this relation (HR 0.73, 95% CI 0.50–1.07). Those with elevated depression symptoms alone had an increased mortality risk (fully adjusted model HR 1.39, 95% CI 1.05–1.84). Having both elevated anxiety and depressive symptoms was not associated with increased mortality risk (adjusted HR 1.30, 95% CI 0.96–1.74). Elevated depressive symptoms were associated with excess mortality risk in people with Type 2 diabetes not using insulin. No significant association with mortality was found among people with elevated anxiety symptoms. Having both elevated anxiety and depressive symptoms was not associated with mortality. The hypot Continue reading >>

How To Deal With Hypoglycemia Anxiety

How To Deal With Hypoglycemia Anxiety

I have strong memories of hypoglycemia anxiety from my early days of living with Type 1 diabetes. I would wake up anxious throughout the night. I was dreaming. I had always hated math, but after weeks of constant carb counting, recording my blood glucose levels, and noting my insulin doses, I had numbers in my head all night. That made me anxious, and so did the fear of hypoglycemia. Sometimes early in the morning, my blood sugar would drop low, making me shaky and sweaty. Those are the symptoms of a panic attack, but also of low blood sugar. Every day people with diabetes (PWD) who use insulin risk hypoglycemia (a low blood sugar level). Each time they check their blood glucose, PWD have to examine the reading and decide how to proceed. We are balancing the need to maintain good blood glucose control with the fear of hypoglycemia. This fear is well founded. Hypoglycemia is not just unpleasant and embarrassing- it can be fatal. I counsel people with Type 1 diabetes, and one of the most stressful parts of diabetes for many people is the experience of being hypoglycemic. I have met a number of people who let their blood sugar levels run high in order to have a break from the lows. Many of them live with substantial guilt about this coping strategy. They often worry about the long-term effects of their elevated blood glucose levels. The fact that they choose the guilt and worry over the risk of going low shows how intensely they fear hypoglycemia. Hypoglycemia anxiety can diminish their quality of life, and often results in an ongoing elevated blood glucose level that causes other health issues. However, we can treat hypoglycemia anxiety and find the courage and motivation to maintain good blood glucose control. There are effective methods to reduce and manage anxiety. Cog Continue reading >>

Anxiety

Anxiety

For other uses, see Anxiety (disambiguation). Anxiety is an emotion characterized by an unpleasant state of inner turmoil, often accompanied by nervous behavior, such as pacing back and forth, somatic complaints, and rumination.[1] It is the subjectively unpleasant feelings of dread over anticipated events, such as the feeling of imminent death.[2] Anxiety is not the same as fear, which is a response to a real or perceived immediate threat,[3] whereas anxiety is the expectation of future threat.[3] Anxiety is a feeling of uneasiness and worry, usually generalized and unfocused as an overreaction to a situation that is only subjectively seen as menacing.[4] It is often accompanied by muscular tension,[3] restlessness, fatigue and problems in concentration. Anxiety can be appropriate, but when experienced regularly the individual may suffer from an anxiety disorder.[3] People facing anxiety may withdraw from situations which have provoked anxiety in the past.[5] There are various types of anxiety. Existential anxiety can occur when a person faces angst, an existential crisis, or nihilistic feelings. People can also face mathematical anxiety, somatic anxiety, stage fright, or test anxiety. Social anxiety and stranger anxiety are caused when people are apprehensive around strangers or other people in general. Furthermore, anxiety has been linked with physical symptoms such as IBS and can heighten other mental health illnesses such as OCD and panic disorder. The first step in the management of a person with anxiety symptoms is to evaluate the possible presence of an underlying medical cause, whose recognition is essential in order to decide its correct treatment.[6][7] Anxiety symptoms may be masking an organic disease, or appear associated or as a result of a medical disord Continue reading >>

Cross-cultural Comparisons Of Anxiety And Depression In Adults With Type 1 Diabetes

Cross-cultural Comparisons Of Anxiety And Depression In Adults With Type 1 Diabetes

Abstract Symptoms of depression and anxiety may be more prevalent in individuals with diabetes; however, little is known about possible differences with respect to social or cultural environment. The aim of this study was to examine cross-cultural differences in prevalence and correlates of symptoms of anxiety and depression in two studies, one in the United Kingdom and one in the United States. Adults with type 1 diabetes participating in two studies in Birmingham, UK, and Pittsburgh, US, completed psychosocial questionnaires including the Beck Depression Inventory and the Beck Anxiety Scale. Results UK subjects were significantly more likely to report moderate–severe levels of anxiety compared to US subjects (17% vs 5%; p < 0.001). Similar proportions of UK and US subjects reported moderate–severe levels of depressive symptomatology (9% vs 7%). Gender differences in symptomatology were more apparent in the US sample than in the UK study population. Multiple regression analysis demonstrated that for the UK study, symptoms of depression, less physical activity and greater frequency of blood glucose monitoring were significantly associated with symptoms of anxiety. Symptoms of depression were also significantly associated with anxiety in the US sample. For UK subjects, depressive symptoms were significantly associated with higher anxiety scores, whereas in the US subjects, anxiety and smoking were significant independent correlates of depression. These data suggest that there may be cultural and/or gender differences in the experience of symptoms of anxiety and depression, and also differences in the relationship between psychological symptomatology and diabetes self-care. Our findings have implications for the understanding of the role psychosocial factors play in t Continue reading >>

Adjustment To Type 1 Diabetes Mellitus And Its Relation With Anxiety And Depression In Pediatric Patients

Adjustment To Type 1 Diabetes Mellitus And Its Relation With Anxiety And Depression In Pediatric Patients

Research Article, Endocrinol Diabetes Res Vol: 2 Issue: 1 Inmaculada Montoya1, Marian Pérez-Marín1*, Ana Soto-Rubio1 and Vicente Prado-Gascó2 1Department of Personality, Psychological Assessment and Treatments, University of Valencia, Blasco Ibáñez Av., 21, Valencia 46010, Spain 2European University of Valencia, General Elio St., 8, Valencia 46010, Spain Corresponding author : Marian Pérez-Marín Facultad de Psicología, Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Universidad de Valencia, Av. Blasco Ibáñez, 21. 46010. Valencia, Spain Tel: +34 963983392 E-mail: [email protected] Received: November 23, 2015 Accepted: February 02, 2016 Published: February 07, 2016 Citation: Montoya I, Pérez-Marín M, Soto-Rubio A, Prado-Gascó V (2016) Adjustment to Type 1 Diabetes Mellitus and its Relation with Anxiety and Depression in Pediatric Patients. Endocrinol Diabetes Res 2:1. doi:10.4172/ecdr.1000111 Abstract Around 26 and 43% of pediatric patients diagnosed with type 1 diabetes mellitus presents psychological problems, being anxiety and depression the more frequent ones. An important factor regarding the wellbeing of these patients is the presence of good adjustment indicators in the process of adapting to this chronic disease.The present study aims to analyze the relationship between the difficulties of adapting to type 1 diabetes mellitus and the presence of clinical symptoms of anxiety and depression in pediatric patients. Our research is an exploratory cross-sectional study in which participated 23 children and adolescents in the age range of 6 to 16 years. All of them were attended in the Pediatric Endocrinology Unit of the General Hospital of Valencia. Our results point out the presence of psychological problems in these patients and a Continue reading >>

Diabetes And Psychiatric Disorders

Diabetes And Psychiatric Disorders

Patterns of co-occurrence of diabetes and psychiatric disorders Comorbidity of diabetes and psychiatric disorders can present in different patterns. First, the two can present as independent conditions with no apparent direct connection. In such a scenario both are outcome of independent and parallel pathogenic pathways. Second, the course of diabetes can be complicated by emergence of psychiatric disorders. In such cases diabetes contributes to the pathogenesis of psychiatric disorders. Various biological and psychological factors mediate the emergence of psychiatric disorders in such context. Third, certain psychiatric disorders like depression and schizophrenia act as significant independent risk factors for development of diabetes. Fourth, there could be an overlap between the clinical presentation of hypoglycemic and ketoacidosis episodes and conditions such as panic attacks. Fifth, impaired glucose tolerance and diabetes could emerge as a side effect of the medications used for psychiatric disorders. Treatment of psychiatric disorders could influence diabetes care in other ways also as discussed in subsequent sections [Box 1]. Diabetes and psychiatric disorders interact in other ways as well. Certain substances of abuse such as tobacco and alcohol can alter the pharmacokinetics of the oral hypoglycemic agents. Moreover, the presence of a comorbid psychiatric disorder like depression could interfere with the management of diabetes by influencing treatment adherence. Similarly certain disorders such as phobia of needles and injections can present difficulties with investigations and treatment processes such as blood glucose testing and insulin injection. Also patients with psychiatric disorders are less likely to seek treatment. Such delays would postpone detection Continue reading >>

The Mental Health Comorbidities Of Diabetes

The Mental Health Comorbidities Of Diabetes

Go to: Depression Prevalence One of the most serious mental health comorbidities associated with diabetes is major depressive disorder. Major depressive disorder affects 6.7% of US adults 18 years or older1 and is more likely to be diagnosed in US adults with diabetes. Overall, rates of depression among individuals with type 1 or type 2 diabetes across the life span are 2 times greater than in the general population.2 A 2011 meta-analysis reported that rates of depression are higher in youth with type 1 diabetes compared with those without the disease, although the differences are not as large as reported in older studies.2 Young adults with type 1 diabetes are especially at risk for poor physical and mental health outcomes and premature mortality.2 Mechanisms Linking Diabetes and Depression Major advances in the past 2 decades have improved understanding of the biological basis for the relationship between depression and diabetes.2 A bidirectional relationship might exist between type 2 diabetes and depression: just as type 2 diabetes increases the risk for onset of major depression, a major depressive disorder signals increased risk for on set of type 2 diabetes.2 Moreover, diabetes distress is now recognized as an entity separate from major depressive disorder.2 Diabetes distress occurs because virtually all of diabetes care involves self-management behavior—requiring balance of a complex set of behavioral tasks by the person and family, 24 hours a day, without “vacation” days. Self management tasks for type 1 diabetes involve carefully checking blood glucose levels to adjust multiple doses of insulin needed day and night. This is balanced with food and physical activity decisions that influence blood glucose levels, most immediately to prevent hypoglycemia, wh Continue reading >>

Relationships Of Diabetes-specific Emotional Distress, Depression, Anxiety, And Overall Well-being With Hba1c In Adult Persons With Type 1 Diabetes

Relationships Of Diabetes-specific Emotional Distress, Depression, Anxiety, And Overall Well-being With Hba1c In Adult Persons With Type 1 Diabetes

Highlights • Diabetes-specific distress was significantly related to glycemic control. • Regimen distress had the strongest association with glycemic control. • Well-being, depression, and anxiety were not significantly related to HbA1c. Abstract Emotional problems are common in adults with diabetes, and knowledge about how different indicators of emotional problems are related with glycemic control is required. The aim was to examine the relationships of diabetes-specific emotional distress, depression, anxiety, and overall well-being with glycosylated hemoglobin (HbA1c). Of the 319 adults with type 1 diabetes attending the endocrinology outpatient clinic at a university hospital in Norway, 235 (74%) completed the Diabetes Distress Scale, the Problem Areas in Diabetes Survey, the Hospital Anxiety and Depression Scale, and the World Health Organization-Five Well-Being Index. Blood samples were taken at the time of data collection to determine HbA1c. Regression analyses examined associations of diabetes-specific emotional distress, anxiety, depression, and overall well-being with HbA1c. The relationship between diabetes-specific emotional distress and HbA1c was tested for nonlinearity. Diabetes-specific emotional distress was related to glycemic control (DDS total: unstandardized coefficient = 0.038, P < .001; PAID total: coefficient = 0.021, P = .007), but depression, anxiety, and overall well-being were not. On the DDS, only regimen-related distress was independently related to HbA1c (coefficient = 0.056, P < .001). A difference of 0.5 standard deviation of baseline regimen distress is associated with a difference of 0.6 in HbA1c. No significant nonlinearity was detected in the relationship between diabetes-specific distress and HbA1c. To stimulate adequate care Continue reading >>

Anxiety Symptoms And Their Association With

Anxiety Symptoms And Their Association With

HbA1c levels in children and adolescents with type 1 diabetes mellitus: a systematic review Kirsten M. Ellens 782800 Bachelor thesis Supervisor: J. Van Son, MSc Department of Medical Psychology Tilburg University Abstract OBJECTIVE – Psychosocial problems are a common phenomenon among youths with diabetes mellitus and can have a detrimental effect on disease management. This study systematically reviewed the evidence focusing on the association between anxiety symptoms and metabolic control in children and adolescents with type 1 diabetes mellitus (T1DM), with special attention paid to the exacerbating and protective aspects of this association, gender and age differences. METHOD – Digital databases (PubMed, PsychINFO, PsychARTICLES, PBSC, Cochrane Library) were searched for articles that investigated the relationship between diabetes, anxiety and HbA1c levels. An adjusted version of the Downs & Black (1998) checklist was used to assess the quality of the found studies. RESULTS – Twenty studies were included, of which seventeen had a quality score of 62.5 % or higher. Direct exacerbating relations between anxiety and glycaemic control were found in eleven studies. Only two studies found a significant protective relationship between anxiety and HbA1c. Girls with T1DM consistently reported to be more anxious than boys with T1DM, but most studies did not investigate the effect of gender in the anxiety-HbA1c connection. Five studies clearly included younger participants, and found that younger children exhibited more fear and better glycaemic control than older children. CONCLUSION – There seems to be an association between anxiety symptoms and HbA1c levels in children and adolescents with T1DM. However, this evidence is still not conclusive. Dif Continue reading >>

Prevalence And Determinants Of Depressive And Anxiety Symptoms In Adults With Type 2 Diabetes In China: A Cross-sectional Study

Prevalence And Determinants Of Depressive And Anxiety Symptoms In Adults With Type 2 Diabetes In China: A Cross-sectional Study

Objectives To evaluate the prevalence and determinants of anxiety and depression and to assess their impact on glycaemic control in participants with type 2 diabetes mellitus. Participants 893 Chinese men and women aged 18–84 years who fulfilled the inclusion criteria. Methods People with type 2 diabetes completed the Pittsburgh Sleep Quality Index and the Zung Self-Rating Anxiety and Depression Scales. Demographic and physiological characteristics were recorded. Multiple logistic regression was used to evaluate the combined effect of factors associated with anxiety and depression and to assess the effects of anxiety and depression on glycaemic control. Results The prevalence of depressive symptoms and anxiety symptoms was 56.1% and 43.6%, respectively. Multivariate logistic regression analysis indicated that anxiety symptoms were associated with being woman, low income, chronic disease, depressive symptoms and poor sleep quality. Depressive symptoms were associated with being woman, older age, low education level, being single, diabetes complications, anxiety symptoms and poor sleep quality. Glycaemic control was not related to anxiety symptoms (OR=1.31, 95% CIs 0.94 to 1.67) or depressive symptoms (OR=1.23, 95% CI 0.85 to 1.63). A combination of depressive symptoms and anxiety symptoms was associated with poor glycaemic control (relative excess risk due to interaction: 4.93, 95% CI 2.09 to 7.87; attributable proportion due to interaction: 0.27, 95% CI 0.12 to 0.45). Conclusions There was a high prevalence of depressive and anxiety symptoms in this Chinese sample of participants, although depression and anxiety were not singly associated with glycaemic control. However, a combination of depressive and anxiety symptoms was negatively correlated with glycaemic control Continue reading >>

Diabetes And Anxiety

Diabetes And Anxiety

Tweet Anxiety can be defined as a fear-based mental state, normally felt as a discomforting emotional state accompanied with physical sensations in the body. Anxiety based mental disorders (i.e. people diagnosed with SAD or GAD) are people who appear anxious about almost everything. This has a detrimental effect on their ability to carry out normal day to day activities. What are the symptoms of anxiety? Symptoms include excessive worry and unnecessary anxiety for numerous activities with symptoms being present and continuous for a minimum of 6 months. Anxiety is difficult to control and is accompanied by somatic symptoms including: Shaking Heart palpitations Excessive perspiration Crying Often it will be a state of mind that is reached after years of dealing with the condition. People diagnosed with diabetes are approximately 20% more likely to suffer from anxiety than those without diabetes. [33] What are the causes of anxiety? Being diagnosed with diabetes can instigate anxiety in a number of ways. People with diabetes may potentially be anxious about how their condition will be perceived by others including friends, family and work colleagues. Anxiety may also arise over what could happen if they were experience a hypo while driving or whilst looking after their children. Excessive worrying can lead to social anxiety. Symptoms of social anxiety include Being fearful of leaving the house or place of comfort Anxiety of being around people, known or strangers Avoidance of social interaction Why might I be anxious? People diagnosed with diabetes may be anxious about the long term implications of their condition. Greater than 70%, of diabetics could develop macrovascular conditions including heart attack and stroke. Furthermore, between 5% and 10% are reported to experie Continue reading >>

The Emotional Side Of Diabetes

The Emotional Side Of Diabetes

Dealing with diabetes puts a lot of attention on blood glucose monitoring and insulin and medications—and those are important, of course. But there is an emotional side to diabetes and effects on your mental health that should be addressed, too. Diabetes interrupts your workday when you have to check your blood glucose. Diabetes means you can't just grab food whenever you want—you have to plan for it. Diabetes prolongs getting ready in the morning as you wash and inspect your feet. Diabetes frustrates you when your taste buds cry out for a pastry instead of an apple. Diabetes makes you worry about your future. All of the time, effort, money, and stress interrupts your emotional stability and introduces emotional complications—and it's okay to be frustrated or overwhelmed or scared. Diabetes and "Being in Control" Let's face it: most of us like being in control, and we don't like feeling that anything is out of our control. When it comes to diabetes, you can feel simultaneously in control and out of control. Out of control: Because of how diabetes affects your body, it is possible to feel that nothing is in your control anymore. You can't eat what you want when you want. You have to take medications or give yourself injections. You can start, perhaps, to feel that your body isn't your own anymore. How to counteract that "out of control" feeling: Taking a step back and an objective look at the situation may help. You can say to yourself, "Yes, diabetes makes me do these things, but diabetes does not run my life." A mantra along those lines—repeated at moments when you're feeling particularly out of control—can help. Also, you can do a mental mind shift: all these steps you're taking to manage your diabetes are actually proactive, healthy steps. You are taking co Continue reading >>

Tips For Dealing With Anxiety And Diabetes

Tips For Dealing With Anxiety And Diabetes

While diabetes is typically a manageable disease, it can create added stress. People with diabetes may have concerns related to regularly counting carbohydrates, measuring insulin levels, and thinking about long-term health. However, for some people with diabetes, those concerns become more intense and result in anxiety. Read on to find out more about the connection between diabetes and anxiety and what you can do to prevent and treat your symptoms. Research has consistently uncovered a strong connection between diabetes and anxiety. One study found that Americans with diabetes are 20 percent more likely to be diagnosed with anxiety than those without diabetes. This was found to be particularly true in young adults and Hispanic Americans. The link between anxiety and glucose levels Stress can affect your blood sugars, though research tends to be mixed as to how. In some people, it appears to raise blood glucose levels, while in others it appears to lower them. At least one study has shown there may also be an association between glycemic control and mental health conditions such as anxiety and depression, particularly for men. However, another study found that general anxiety didn’t affect glycemic control, but diabetes-specific emotional stress did. Other research has found that people with type 1 diabetes seem to be “more susceptible to physical harm from stress” while those with type 2 diabetes weren’t. One’s personality also seems to determine the effect to some extent as well. People with diabetes may become anxious over a variety of things. These can include monitoring their glucose levels, weight, and diet. They may also worry about short-term health complications, such as hypoglycemia, as well as long-term effects. People with diabetes are at higher ri Continue reading >>

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