Adolescents who are newly diagnosed with type 1 diabetes (T1D) are at an increased risk for anxiety and depressive symptoms than those who have been living with diabetes for several years, according to findings presented at the National Association of Pediatric Nurse Practitioners (NAPNAP) virtual conference held April 26 to 29, 2022.

“The chronic nature of T1D, combined with the demands of the daily treatment regimen, increase the risk of mental health comorbidity,” said coauthors Kaitlyn Rechenberg, PhD, MPH, APRN, and Rebecca Koerner, MSN, APRN, of the University of South Florida College of Nursing. “Anxiety and depressive symptoms are associated with out-of-range glycemic control, severe hypoglycemia, and ketoacidosis,” the authors noted. “Reducing the burden of anxiety and depressive symptoms may be a key part of improving glycemic control and reducing long-term complications in this high-risk population.”

Type 1 diabetes is one of the most prevalent chronic conditions in children and adolescents with the incidence rising by 3% every year. Currently, over 200,000 youth younger than 18 years of age are living with T1D in the US. Anxiety and depressive symptoms are 2 to 3 times more prevalent in adolescents living with T1D than those living without a chronic disease, the researchers reported.

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The purpose of the study was to examine anxiety and depression symptom rates among adolescents with T1D by school grade level. Participants were aged 13 to 17 years, living with T1D for more than 6 months with no other chronic medical conditions, and able to speak and read English fluently. Most of the participants were non-Hispanic White (90%), and boys (58%). Half of the adolescents received diabetes treatment by injection and the other half used insulin pumps.

Participants were evaluated for general anxiety symptoms (Generalized Anxiety Disorder-7), and general depressive symptoms (Patient Health Questionnaire-2).

Anxiety and Depression Scores in Teens With Type 1 Diabetes

Mean general anxiety scores indicated mild to moderate anxiety symptoms (9.78) and mean depressive scores were 2.75 (above 3 indicates major depressive disorder). Participants in middle school were more likely to report depressive symptoms than participants in high school (P <.01).

“Younger adolescents may be at a higher risk of clinically significant symptom burden from depression,” stated the authors. To identify and treat these patients earlier, the authors suggested that teens with T1D need to be screened for depression and anxiety at regular clinic visits, especially those newly diagnosed with diabetes.

Future research should be aimed at tailoring psychosocial interventions with particular attention to adolescents’ age and disease duration, the authors concluded.


Rechenberg K, Koerner R. Anxiety and depressive symptoms in adolescents with type 1 diabetes. Presented at: National Association of Pediatric Nurse Practitioners (NAPNAP) virtual conference; April 26-19, 2022.