Subject(s)
Diabetes Mellitus , Social Media , Diabetes Mellitus/therapy , Educational Status , Humans , InternetABSTRACT
A significant increase in children <6 years of age being diagnosed with type 1 diabetes (T1D) is occurring. The parents (caregivers) of these children have full responsibility for the complex and individualized management while having to deal with the emotional stress of caring for a child with a chronic condition. This article will provide a summary of the diagnosis and recommended medical treatment for this special age group of children. Also presented will be common day-to-day family management issues for health care providers to consider as they provide care for this most common endocrine chronic condition.
Subject(s)
Diabetes Mellitus, Type 1/therapy , Caregivers/psychology , Child, Preschool , Choice Behavior , Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/psychology , Humans , Infant , Infant, Newborn , Insulin Infusion Systems , Parents/psychologyABSTRACT
OBJECTIVE: To investigate differences in risk factors for depression and anxiety, such as central nervous system involvement in systemic lupus erythematosus (SLE)/mixed connective tissue disease (MCTD), by comparing youth with SLE/MCTD to peers with type 1 diabetes mellitus (T1D). STUDY DESIGN: We conducted a cross-sectional study of 50 outpatient pairs, ages 8 years and above, matching subjects with SLE/MCTD and T1D by sex and age group. We screened for depression, suicidal ideation, and anxiety using the Patient Health Questionnaire-9 and the Screen for Childhood Anxiety Related Emotional Disorders, respectively. We collected parent-reported mental health treatment data. We compared prevalence and treatment rates between subjects with SLE/MCTD and T1D, and identified disease-specific risk factors using logistic regression. RESULTS: Depression symptoms were present in 23%, suicidal ideation in 15%, and anxiety in 27% of participants. Compared with subjects with T1D, subjects with SLE/MCTD had lower adjusted rates of depression and suicidal ideation, yet poorer rates of mental health treatment (24% vs 53%). Non-White race/ethnicity and longer disease duration were independent risk factors for depression and suicidal ideation. Depression was associated with poor disease control in both groups, and anxiety with insulin pump use in subjects with T1D. CONCLUSION: Depression and anxiety are high and undertreated in youth with SLE/MCTD and T1D. Focusing on risk factors such as race/ethnicity and disease duration may improve their mental health care. Further study of central nervous system and other disease-related factors may identify targets for intervention.
Subject(s)
Anxiety/epidemiology , Depression/epidemiology , Diabetes Mellitus, Type 1/complications , Lupus Erythematosus, Systemic/complications , Mental Health , Mixed Connective Tissue Disease/complications , Risk Assessment/methods , Adolescent , Anxiety/etiology , Child , Cross-Sectional Studies , Depression/etiology , Diabetes Mellitus, Type 1/psychology , Female , Humans , Lupus Erythematosus, Systemic/psychology , Male , Mixed Connective Tissue Disease/psychology , Pennsylvania/epidemiology , Prevalence , Risk FactorsABSTRACT
Of 151 youth with type 1 diabetes who were screened for peripheral neuropathy, and received nerve conduction studies, 11% were diagnosed with Diabetic Peripheral Neuropathy (DPN). DPN can occur in young children, with short diabetes duration, and good diabetes control. National guidelines for screening children for DPN should be developed.
Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Diabetic Neuropathies/epidemiology , Mass Screening/methods , Neural Conduction , Peripheral Nervous System Diseases/epidemiology , Adolescent , Age of Onset , Child , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 1/physiopathology , Diabetic Neuropathies/etiology , Diabetic Neuropathies/physiopathology , Female , Glycated Hemoglobin/metabolism , Guidelines as Topic , Humans , Male , Peripheral Nervous System Diseases/etiology , Peripheral Nervous System Diseases/physiopathology , Philadelphia/epidemiology , Physical Examination , Prevalence , Risk Factors , Sensitivity and Specificity , Surveys and Questionnaires , Young AdultABSTRACT
The purpose of this article is to describe diabetes diagnosed during the first 6 months of life. Neonatal diabetes, also known as congenital diabetes, presents a unique set of challenges for the pediatric healthcare provider. Neonatal diabetes is not type 1 diabetes. While the etiology of type 1 diabetes is multifactorial and includes genetic and environmental factors, neonatal diabetes is strictly a genetic condition. Management of children with neonatal diabetes, treatment of the disease, psychosocial considerations for the family, and nursing care required for this population are all included in this article. Unique issues related to the diagnosis of a genetic mutation resulting in a defect in the potassium channel are also discussed.
