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Sad or Angry Teens have Less Success with Diabetes Control

Posted: Tuesday, March 17, 2009

Teens with Type 1 diabetes are responsible for taking insulin, monitoring blood sugar levels and keeping doctor visits too. Now, a new study suggests that feelings such as anger or sadness could interfere with teens’ diabetes management.

Not only do teens with Type 1 diabetes have the normal adolescent concerns of school, work and social activities, but they are responsible for taking insulin, monitoring blood glucose (blood sugar) levels and keeping doctor visits too. Now, a new study suggests that feelings such as anger or sadness could interfere with teens’ diabetes management.

“Adolescence is a difficult time to manage diabetes, for multiple reasons: some of them are physiological, like puberty; some are psychological, such as increasing autonomy. Also, there’s a rise during adolescence of negative emotions,” said Cynthia Berg, Ph.D., chairperson of the psychology department at the University of Utah in Salt Lake City.

Berg, a study co-author, and colleagues had 62 adolescents with Type 1 diabetes complete daily diaries for two weeks, detailing their mood, average blood glucose levels, overall confidence in their ability to manage their diabetes and ability to manage daily diabetes tasks, such as eating healthy foods and taking insulin.

During the two-week study period, when teens reported more positive feelings, such as happiness or excitement, they tended to have lower — nearer normal — blood glucose levels. In contrast, when teens reported negative feelings, daily diary entries revealed a tendency toward higher blood glucose levels.

Researchers measured positive and negative emotions on a one- to five-point scale. “The important issue is that for every one-point change in emotion, there is a rather sizeable change in blood glucose,” Berg said.

Ann Goebel-Fabbri, Ph.D., a psychologist at Joslin Diabetes Center in Boston, cautioned that the act of entering the blood glucose number in journals might cloud teens’ moods. As a result, “they may feel negatively or positively charged from that result,” she said.

“The take-home message for health care providers, parents and teens is that both emotions can potentially influence their confidence in blood sugar management,” Goebel-Fabbri said. “At the same time, it can go in the opposite direction — the actual outcomes can also influence their emotions. It’s a bidirectional relationship.”

Fortenberry KT, et al. Perceived diabetes task competence mediates the relationship of both negative and positive affect with blood glucose in adolescents with Type 1 diabetes.

Source: Diabetes In Control: Annals of Behavioral Medicine 31(1), 2009.