OBJECTIVE: The principal aim of this study was to examine the longitudinal interplay of depressive symptoms, diabetes-specific perceptions and distress, and glycemic control in emerging adults with Type 1 diabetes.
METHODS: Emerging adults with Type 1 diabetes (18-30 years old) participated in a 2-wave longitudinal study spanning 5 years (N = 164 at Time 1). Patients completed questionnaires on depressive symptoms, diabetes-specific distress (treatment-related, food-related, emotional, and social support problems), and illness perceptions (consequences and personal control) at baseline and follow-up. HbA1c values were obtained from treating clinicians. The authors investigated the directionality of effects using cross-lagged path analysis.
RESULTS: Stronger perceptions of control predicted a relative decrease in treatment-related problems 5 years later, whereas stronger perceptions of consequences predicted a relative increase in depressive symptoms, treatment-related, food-related, emotional, and social support problems over time. Furthermore, higher depressive symptoms predicted a relative increase in social support problems 5 years later. None of the study variables were related to changes in glycemic control over time.
CONCLUSIONS: Our findings stress the importance of addressing patients' perceptions and beliefs about their diabetes. Clinicians should find a delicate balance between stressing the importance of diabetes care and preventing patients from feeling overwhelmed or engulfed by the burden of diabetes care. Furthermore, our findings advocate for depression screening and treatment as key elements in holistic diabetes care, given the relatively high prevalence of elevated depressive symptoms in this population.