1. Prevalence of Poor Glycemic Control and Depression Among Diabetic Adolescent Youth Presented By: Atwater K and Wilson S Prairie View A & M University Prevalence of Poor Glycemic Control and Depression Among Diabetic Adolescent Youth Presented By: Atwater K and Wilson S Prairie View A & M University Abstract Background Methods Conclusion/ Discussion Results References Background: Prevalence of diabetes mellitus (DM) is increasing. In the United States alone roughly 25.8 million adults and children are diagnosed with DM. Objective: Conduct meta-analysis to examine the prevalence of depression among adolescent children diagnosed with diabetes mellitus Method: The Meta-analysis conducted using peer reviewed journals. Descriptive statistics were then computed and used to analyze the percentage of the sample size population who reported having depression along with poor glycemic control (HbA1c). The age group analyzed were to be between the 10- 25 yrs old with a diabetes duration of 2-10 years. This was to calculate what population was most at risk of poor glycemic control and in effect, at highest risk of experiencing depression. Duration was analyzed to show the poor glycemic control was for a period of time, not just post-diagnosis. Results: 22% of the adolescent population who reported experiencing depression had poor glycemic control. Of the 1026 adolescents in the analysis, those at 15 years of age who had poor glycemic control, were at highest risk of depression Conclusion: Depression has a direct influence on poor glycemic control on youth with a prolonged duration of diabetes. Background: Prevalence of diabetes mellitus (DM) is increasing. In the United States alone roughly 25.8 million adults and children are diagnosed with DM. Objective: Conduct meta-analysis to examine the prevalence of depression among adolescent children diagnosed with diabetes mellitus Method: The Meta-analysis conducted using peer reviewed journals. Descriptive statistics were then computed and used to analyze the percentage of the sample size population who reported having depression along with poor glycemic control (HbA1c). The age group analyzed were to be between the 10- 25 yrs old with a diabetes duration of 2-10 years. This was to calculate what population was most at risk of poor glycemic control and in effect, at highest risk of experiencing depression. Duration was analyzed to show the poor glycemic control was for a period of time, not just post-diagnosis. Results: 22% of the adolescent population who reported experiencing depression had poor glycemic control. Of the 1026 adolescents in the analysis, those at 15 years of age who had poor glycemic control, were at highest risk of depression Conclusion: Depression has a direct influence on poor glycemic control on youth with a prolonged duration of diabetes.  The prevalence of diabetes mellitus (DM) among children and adults living in the United States is roughly 25.8 million (ADA, 2011)  1 in 500 children are diagnosed with DM (Chase, 2006)  Children diagnosed with DM and self-reported feeling of depression were less likely to have good glycemic control (Lernmark et al. 1999)  It is imperative to further examine the extent to which children diagnosed with diabetes are currently experiencing depression, hence, impeding diabetes self-management  The prevalence of diabetes mellitus (DM) among children and adults living in the United States is roughly 25.8 million (ADA, 2011)  1 in 500 children are diagnosed with DM (Chase, 2006)  Children diagnosed with DM and self-reported feeling of depression were less likely to have good glycemic control (Lernmark et al. 1999)  It is imperative to further examine the extent to which children diagnosed with diabetes are currently experiencing depression, hence, impeding diabetes self-management  Center for Disease Control and Prevention. Diabetes Successes and Opportunities for Population-Based Prevention and Control at a Glance. Nation Center for Chronic Disease Prevention and Health Promotion Division of Diabetes Translation. 2011; 1-4  Lernmark B, Persson B, Fisher L, Rydelius PA. Symptoms of depression are important to psychological adaptation and metabolic control in children with diabetes mellitus. Diabet Med. 1999;16(1):14-22.  Ciechanowski PS, Katon WJ, Russo JE, Hirsch IB. The relationship of depressive symptoms to symptom reporting, self-care, and glucose control in diabetes. Gen Hosp Psychiatry. 2003;  Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Arch Intern Med. 2000;160:3278-3285.  Chase, HP. Understanding Diabetes (11 edition). 2006. Denver, Colorado: Barbra Davis Center for Childhood Obesity.  Black SA, Markides KS, Ray LA. Depression predicts increased incidence of adverse health outcomes in older Mexican Americans with type 2 diabetes. Diabetes Care. 2003;26(10):2822–8.  Katon WJ, Rutter C, Simon G, et al. The association of comorbid depression with mortality in patients with type 2 diabetes. Diabetes Care. 2005;28(11):2668–72.  Katon W, Fan MY, Unutzer J, Taylor J, Pincus H, Schoenbaum M. Depression and diabetes: a potentially lethal combination. J Gen Intern Med. 2008;23(10):1571–5.  Lin EH, Heckbert SR, Rutter CM, et al. Depression and increased mortality in diabetes: unexpected causes of death. Ann Fam Med. 2009;7(5):414–21.  de Groot M, Anderson R, Freedland KE, Clouse RE, Lustman PJ. Association of depression and diabetes complications: a meta-analysis. Psychosom Med. 2001;63(4):619–30.  Poor glycemic control has a direct effect on depression in adolescents with a prolonged duration of diabetes.  Sex does not play a factor in depression development.  Diabetes is the leading cause of chronic kidney disease and is interconnected to complications associated with high blood pressure, heart disease and stroke, neuropathy, blindness, amputations, and mortality (ADA, 2013)  Individuals diagnosed with diabetes will most likely have a shorter life expectancy (CDC, 2011)  The risk of death is double in comparison to non-diabetic individual of a similar age (CDC, 2011)  Diabetic patients with co-morbid depression have a higher rates of mortality (Black, 2003; Katon, 2005; Katon, 2008; Lin EH, 2009; Heckbert, 2010)  Poor glycemic control has a direct effect on depression in adolescents with a prolonged duration of diabetes.  Sex does not play a factor in depression development.  Diabetes is the leading cause of chronic kidney disease and is interconnected to complications associated with high blood pressure, heart disease and stroke, neuropathy, blindness, amputations, and mortality (ADA, 2013)  Individuals diagnosed with diabetes will most likely have a shorter life expectancy (CDC, 2011)  The risk of death is double in comparison to non-diabetic individual of a similar age (CDC, 2011)  Diabetic patients with co-morbid depression have a higher rates of mortality (Black, 2003; Katon, 2005; Katon, 2008; Lin EH, 2009; Heckbert, 2010) Systematic Review of Literature PubMed, Science Direct [Diabetes AND Depression AND Youth; Adolescent Depression and Glycemic Control; Diabetes Self- management and Depression in Adolescents] Inclusion Criteria : N<200, Outcome Variables: Depression, Diabetes Duration, HbA1c, Age Exclusion Criteria: N > 200 Meta Analysis N= 1026  Poor glycemic control among adolescents is associated with depression  Children with diabetes whom have had diabetes for an extended period of time, have an average A1c value of 9.2% indicating many adolescents have poor glycemic control (>=8% is categorized as “poor” control)  Nearly ¼ of the participants within the meta-analysis whom displayed poor glycemic control were also depressed  Note: the (*) above indicates the value is an average calculated by using each study  Poor glycemic control among adolescents is associated with depression  Children with diabetes whom have had diabetes for an extended period of time, have an average A1c value of 9.2% indicating many adolescents have poor glycemic control (>=8% is categorized as “poor” control)  Nearly ¼ of the participants within the meta-analysis whom displayed poor glycemic control were also depressed  Note: the (*) above indicates the value is an average calculated by using each study  The male and female populations with poor glycemic control were at equal risk of becoming depressed.  There was no significant difference in distribution between either group.  Sex does not have a significant effect on whether or not an adolecent with poor glycemic control will develop depression.  The male and female populations with poor glycemic control were at equal risk of becoming depressed.  There was no significant difference in distribution between either group.  Sex does not have a significant effect on whether or not an adolecent with poor glycemic control will develop depression. Table 1: Demographic of Sample Population N1026 Male487 Female539 Age (years)*15.4 Diabetes Duration*6.0 A1c*9.2% Depressed240 Graph 1: % Depressed Diabetic vs. % Non-Depressed Diabetic Adolescents Graph 2: Distribution for Non-Depressed vs. Depressed Adolescents (n=1026)