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This study explored the frequency of adolescents with diabetes who endorse suicidality on the Patient Health Questionnaire (PHQ-9) with varying degrees of depression scores. Additionally, compared whether diabetes distress levels from the Problem Areas in Diabetes-Teen (PAID-T) assessment tool is associated with and without suicidal ideation. Χ2 analysis was used to assess differences in subjects with or without suicidal ideation based on depression severity. Since all the data were nonparametrically distributed (Shapiro–Wilk test, p <.05), Kruskal–Wallis test assessed differences in continuous variables. Overall, 27 of 355 adolescents screened endorsed suicidal ideation. Both PHQ-9 [13 (9–17.8) vs 1 (0–4.5)] and PAID-T [88 (61.8–104.5) vs 40 (30–58.8)] scores were significantly higher in patients with suicidal ideation. The frequency of suicidal ideation increased with the severity of depression. The frequency of severe depression was higher in adolescents with type 2 diabetes (n = 48) than in type 1, but there was no difference in suicidality. Adolescents with no demonstrable or minimal depression can still have potential suicidal ideation. Suicidality is a separate construct that should be screened routinely and apart from any measures screening for distress or adjustment disorders associated with adolescents experiencing life-long chronic conditions in a healthcare follow-up setting. [ABSTRACT FROM AUTHOR]

Background: This study was designed to determine the effects of diabetes type and gender on depression risk determined by a highly sensitive screening questionnaire in adolescents. Glycemic control and counseling affect were also studied. Methods: A retrospective chart review of patients seen between 2013 and 2015 was performed. Five hundred and thirty adolescents with type 1 (T1DM) or 2 (T2DM) diabetes mellitus completed the Patient Health Questionnaire-9 (PHQ-9) to identify depressive symptoms. Hemoglobin A1c (HbA1c) was measured when the PHQ-9 was given, and at 1 year. Patients with increased depression risk were referred for counseling and comparisons were made between those who did and did not attend. Results: Females with T2DM, but not males, had increased depression compared to T1DM. Females had increased depression compared to males in T1DM (p = 0.046) and a near significant increase in T2DM (p = 0.069). In T1DM, but not T2DM, HbA1c levels were increased in high and moderate, compared to low, risk depression risk groups (p = 0.007). Follow-up HbA1c was unchanged 1 year later and there were no differences between those involved in counseling and those who refused to attend. Sex and type of diabetes had no effect on response to counseling. Conclusions: These results demonstrate increased depression in adolescents with T2DM compared to T1DM and in females compared to controls. Glycemic control did not change in adolescents who reported moderate to severe symptoms of depression and received counseling intervention compared to adolescents who declined counseling. [ABSTRACT FROM AUTHOR]

Background: This study was designed to determine the effects of diabetes type and gender on depression risk determined by a highly sensitive screening questionnaire in adolescents. Glycemic control and counseling affect were also studied. Methods: A retrospective chart review of patients seen between 2013 and 2015 was performed. Five hundred and thirty adolescents with type 1 (T1DM) or 2 (T2DM) diabetes mellitus completed the Patient Health Questionnaire-9 (PHQ-9) to identify depressive symptoms. Hemoglobin A1c (HbA1c) was measured when the PHQ-9 was given, and at 1 year. Patients with increased depression risk were referred for counseling and comparisons were made between those who did and did not attend. Results: Females with T2DM, but not males, had increased depression compared to T1DM. Females had increased depression compared to males in T1DM (p = 0.046) and a near significant increase in T2DM (p = 0.069). In T1DM, but not T2DM, HbA1c levels were increased in high and moderate, compared to low, risk depression risk groups (p = 0.007). Follow-up HbA1c was unchanged 1 year later and there were no differences between those involved in counseling and those who refused to attend. Sex and type of diabetes had no effect on response to counseling. Conclusions: These results demonstrate increased depression in adolescents with T2DM compared to T1DM and in females compared to controls. Glycemic control did not change in adolescents who reported moderate to severe symptoms of depression and received counseling intervention compared to adolescents who declined counseling. [ABSTRACT FROM AUTHOR]

Objective: Performance in providing optimal type 1 diabetes care has historically focused on only one metric, HbA1c. Our objectives were to design and test a metric that evaluated overall quality of care and to use this metric to drive improvement within our diabetes program. Methods: The Type 1 Diabetes Care Index (T1DCI) aggregates missed opportunities for best practices into a composite score that reflects overall program performance. Elements of optimal care that should be reliably delivered were compiled into 14 domains over three areas: (1) Delivery of patient care, (2) Preventative Screening, (3) Psychosocial support. The T1DCI is the aggregate number of missed opportunities to provide quality care over a given time period. A lower T1DCI reflects better care and overall improved system performance. Results: The T1DCI was easy to calculate and implement, and was well accepted by our diabetes team. The annual T1DCI progressively decreased from 5,338 at baseline to 3,821 after 10 months of utilization, a 14% reduction. Improvements in care were realized across some index domains and areas for focusing improvement efforts were recognized in others. New initiatives to provide optimal care were created. Conclusions: The T1DCI is a useful metric to evaluate the ability of our program to deliver optimal care, and to document performance improvement across a broad range of domains. Disclosure: K. Obrynba: Consultant; Self; Dexcom, Inc. J.A. Indyk: None. K. Gandhi: None. D.A. Buckingham: None. A.M. Kramer: None. K. Hong: None. B. Glick: None. T. Wells: None. T.C. Barnard-Kirk: None. M.L. Smith: None. A.M. Moffett: None. M.K. Kamboj: None. [ABSTRACT FROM AUTHOR]