Shideh Majidi

Anxiety in Children and Adolescents With Type 1 Diabetes

Although anxiety is a normal and developmentally appropriate experience of childhood and anxiety disorders are among the most commonly diagnosed disorders, the prevalence of anxiety symptomatology and anxiety disorders in children with type 1 diabetes (T1D) is not well documented. Most studies have focused on anxiety-related syndromes associated with T1D including fear of hypoglycemia, specific phobia of needles (i.e., needle anxiety), and anxiety related to uptake of new and sophisticated diabetes technology (e.g., continuous glucose monitors, continuous subcutaneous infusion therapy), but the extant literature is sparse, and more research is greatly needed. Identification, prevention, and treatment of anxiety are critical to providing comprehensive diabetes care and management. This review provides a summary of the literature focused on anxiety in children and adolescents with T1D with suggestions for future research and clinical implications.

The effect of insurance status and parental education on glycemic control and cardiovascular disease risk profile in youth with Type 1 Diabetes

BackgroundAdult studies have shown a correlation between low socioeconomic status and Type 1 Diabetes complications, but studies have not been done in children to examine the effect of socioeconomic status on risk for future complications. This study investigates the relationship between insurance status and parental education and both glycemic control and cardiovascular disease (CVD) risk factors in youth with type 1 diabetes.MethodsA cross-sectional study of 295 youth with established type 1 diabetes who underwent examination with fasting blood draw and reported insurance status and parental education.ResultsYouth with type 1 diabetes and public insurance had higher hemoglobin A1c (HbA1c), body mass index, hs-CRP, and blood pressure (p < 0.05) than those with private insurance. Insulin regimen varied between insurance groups, and differences in HbA1c and CVD risk factors, except for diastolic blood pressure (DBP), were no longer evident after controlling for insulin regimen. Parental education was not associated with HbA1c or CVD risk factors.ConclusionsYouth with type 1 diabetes and public insurance have worse glycemic control and elevated CVD risk factors compared to those with private insurance, but this was no longer seen when insulin regimen was controlled for. Further research is needed to look at differences between those with public insurance and private insurance that contribute to differences in type 1 diabetes outcomes, and to identify modifiable risk factors in pediatric patients in order to focus earlier interventions to decrease and prevent future diabetes complications.

Update on care of children with type 1 diabetes.

Key Points Incidence of T1D is increasing. T1D is a lifelong condition that can result in acute and chronic complications. Diagnosis of T1D is based on clinical symptoms, blood glucose levels, and hemoglobin A1c. Intensive glycemic control decreases complications of T1D, which include cardiovascular disease, nephropathy, retinopathy, and neuropathy. Significant research is continuing in the field of T1D, including investigations into the prevention and cure of T1D.

Authoritarian parenting style predicts poorer glycemic control in children with new-onset type 1 diabetes

To examine cross‐sectional and longitudinal associations among parenting styles (ie, authoritative, authoritarian, and permissive) and youth glycated hemoglobin (HbA1c) in a cohort of families of children with new‐onset type 1 diabetes (T1D).