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Press Releases: National

April 3, 2006

Poor Blood Sugar Control Linked to Depression in Youth With Diabetes

Kaiser Permanente researcher leads study on possible indicators behind higher rates of depression

OAKLAND, Calif. – Poor blood sugar control and frequent emergency room visits are just two of the telltale signs that children and adolescents with diabetes may be suffering from symptoms of depression, finds a new study by researchers at Kaiser Permanente Southern California and five other study sites. These results are from the first large population-based study to look at diabetes in youth in the United States.


The study, which found that girls were more likely to have symptoms of depression than boys, estimated the prevalence of depression among 2,672 youth with diabetes, aged 10 to 21, as well as possible factors associated with higher rates of depression. The results appear in the April 3 issue of Pediatrics.

Fourteen percent of study participants had symptoms of mild depression, while nearly 9 percent had symptoms of moderate to severe depression. Depressive symptoms increased in both boys and girls in tandem with increases in Hemoglobin A1c, which is measured to determine long-term blood sugar control. Boys with moderate or severe depressive symptoms had 80 percent more emergency room visits, whereas girls had 60 percent more ER visits than did youth with no symptoms of depression.

"This study found several clear signs that a child or adolescent with diabetes may be experiencing symptoms of depression and may benefit from additional mental health screening from physicians and other health care professionals," says Jean Lawrence, ScD, MPH, the study’s lead author and an epidemiologist with the Department of Research & Evaluation in Kaiser Permanente’s Southern California region. Additionally, she notes, "health care providers should also consider mental health evaluations and interventions for youth who have a history of depression and who are not currently in treatment, since depression is associated with poor blood sugar control."

In addition to poor blood sugar control and more trips to the ER, researchers discovered that girls who had diabetes, along with additional health problems, were more likely to show signs of depression, compared with girls with diabetes alone. At the same time, boys with type 2 diabetes were more likely to have moderately to severely depressed mood than boys with type 1 diabetes.

"This is the first study to document the frequency of depression symptoms among youth with diabetes, in a large population-based sample," says Michael Engelgau, MD, acting director of the Division of Diabetes Translation at the Centers for Disease Control and Prevention (CDC). "The findings of an association of depression and poor glycemic control, and of a higher frequency of depression among girls have great relevance for improving diabetes control and the quality of life for these young people and their families."

Eighty-five percent of the study's participants had type 1 diabetes, while 14 percent had type 2 diabetes. Lawrence points out that study participants were not screened for clinical depression, but rather, the study aimed to identify those at risk for depression. Lawrence also reports that youth with diabetes were no more likely to show signs of depression than youth without diabetes from similar age and racial/ethnic groups who had undergone screening using the same methodology in previous studies.

The study is funded by the Centers for Disease Control and Prevention and the National Institutes of Health, and is part of SEARCH for Diabetes in Youth, a six-center, population-based study focusing on physician-diagnosed diabetes in children and youth in the United States. SEARCH, a 10-year study that began in 2000, is aimed at identifying diabetes cases among more than 5 million American children each year. SEARCH has study centers in California, Colorado, Hawaii, Ohio, South Carolina and Washington. "The SEARCH program and studies like this one are indicative of the gains we can make in the medical community as a whole, when we partner in research, prevention, and control efforts," added Engelgau.

Kaiser Permanente has research offices in California, Oregon, Hawaii, Georgia, Colorado, Maryland, and Ohio. Results of research conducted by Kaiser Permanente physicians and investigators have been published in the Journal of the American Medical Association, the New England Journal of Medicine, the American Journal of Obstetrics & Gynecology, the American Journal of Public Health, Pediatrics, The Permanente Journal, and other clinical journals.

About Kaiser Permanente
Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve 8.6 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: