Emotional Disorder In Children With Type 1 Diabetes Mellitus And Its Influencing Factors And Its Influence On Glycemic Control

Objective:To understand the incidence of emotional disorders in children with type 1 diabetes and its influencing factors,and analyze its impact on blood glucose control,so as to prevent or early detect emotional disorders in children with diabetes and timely intervention to promote the healthy development of children’s body and mind.Methods:Forty-seven cases diagnosed with type 1 diabetes who were in the age of 8-16 years old in Shanxi Children’s Hospital from May 2022 to February 2023 were selected as the case group,and 108 cases of children aged 8-16 years old without other chronic diseases with the age and gender matching were selected as the control group.In the form of a questionnaire,with the consent of the parents and children,the children themselves to fill in,and back on the spot.The questionnaires included “The Screen for Child Anxiety Related Emotional Disorders(SCARED)and Self-Rating Scale for Depressive Disorder in Childhood(DSRSC)”.If the score of any scale exceeded the limit,it was positive for emotional disorder.Meanwhile,general data of children in the case group including gender,age,course of disease,age at onset,height and weight were collected,and calculate its body mass index(BMI).Glycated hemoglobin(Hb A1c),fasting C-peptide,fasting blood glucose(FBG),and current treatment options including insulin dosing and insulin consumption were monitored at this visit.The collected data were organized into Excel spreadsheets with a unified format,and SPSS21.0 statistical software was used for data analysis.Results:1.General: In the 47 cases group,there were 17 boys(36.17%)and 30 girls(63.83%),with the minimum age of 8 years and the maximum age of 16 years.In the control group,there were 45 boys(41.67%)and 63 girls(58.33%)in 108 children,with the minimum age of 8 years and the maximum age of 15 years.There was no significant difference in the age(Z=0.425,P > 0.05)and gender(c2=0.412,P > 0.05)distribution of children between the two groups.2.Occurrence of emotional disorders in two groups: 24 of 47 children in the case group were positive for emotional disorders,with the detection rate of 51.06%,while 28 of 108 children in the control group were positive for emotional disorders,with the detection rate of 25.93%.The results showed that the difference between the two groups was statistically significant(P < 0.05).Among them,21 cases(44.68%)in the anxiety symptom screening group showed anxiety symptoms,and 24 cases(22.22%)in the control group showed anxiety symptoms.The results of comparative analysis showed that the difference between the two groups was statistically significant(P < 0.05).Ten cases(21.28%)in the case group and 11 cases(10.19%)in the control group showed depressive symptoms after depression symptom screening.The comparison and analysis results showed that there was no significant difference between the two groups(P > 0.05).At the same time,seven children(14.89%)in the case group were double positive for anxiety and depression,and seven children(6.48%)in the control group were double positive.The comparison and analysis results showed that the difference between the two groups was not statistically significant(P > 0.05).3.Distribution of emotional disorders: 21 patients(87.50%)in the case group had positive anxiety screening scale,and 24 patients(85.71%)in the control group had positive anxiety screening scale.The results of comparative analysis showed that there was no significant difference between the two groups(P > 0.05).Ten cases(41.67%)in the case group and 11 cases(39.29%)in the control group were positive for the depression screening scale.The results of comparative analysis showed that there was no significant difference between the two groups(P > 0.05).Seven children(29.17%)in the case group were double positive,and seven children(25.00%)in the control group were double positive.The results of comparative analysis showed that there was no significant difference between the two groups(P > 0.05).4.Blood glucose control: M(P25,P75)of Hb A1 c in the emotional disorder group was 9.4%(8.53%,11.70%),and M(P25,P75)of non-emotional disorder group was7.4%(6.80%,8.60%).The comparative analysis showed that the difference between the two groups was statistically significant(P < 0.01).5.The results of single factor analysis showed that the differences of glycated hemoglobin,fasting blood glucose and insulin dosage in the occurrence of emotional disorders were statistically significant(all P < 0.05).6.Multivariate Logistic regression analysis showed that the difference of fasting blood glucose in the occurrence of emotional disorders was statistically significant(P <0.05).Conclusion:The incidence rate of emotional disorders in children with type 1 diabetes is higher,and anxiety disorders are the main ones.However,the distribution of emotional disorders is not different from that of ordinary children in the general population.Glycemic control in children with type 1 diabetes mellitus who share emotional disorders is second to that in children without emotional disorders.High fasting blood glucose is a risk factor of emotional disorder in children with type 1 diabetes.