Depression in Youth-Onset Type 2 Diabetes
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PEDIATRIC TYPE 2 AND MONOGENIC DIABETES (O PINHAS-HAMIEL, SECTION EDITOR)
Depression in Youth-Onset Type 2 Diabetes Lauren D. Gulley 1,2
&
Lauren B. Shomaker 1,2,3
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review The current review summarizes extant knowledge regarding the prevalence of depression in youth-onset type 2 diabetes (T2D) and how depression might impact glycemic control through stress-related behavioral and physiological mechanisms. The current review also discusses depression intervention studies in adult-onset T2D, as there are no such studies in youth-onset T2D, and provides recommendations for clinical research. Recent Findings The prevalence of elevated depression symptoms in youth-onset T2D is approximately 20%. Some studies suggest depression may negatively impact glycemic control through inadequate medication adherence and disordered eating, but there is a dearth of studies investigating associations with depression and physical activity/sedentary time, sleep, and stressrelated physiological mechanisms. In adult-onset T2D, evidence-based behavioral interventions tailored to address diabetesrelated issues have shown positive effects for depression and glycemic control. Summary Future research is needed to characterize the epidemiology of depression in youth-onset T2D and test interventions to improve depression, glycemic control, and health outcomes in this specific pediatric population. Keywords Type 2 diabetes . Adolescence . Depression . Adherence . Glycemic control
Introduction Youth-onset (age < 20 years) type 2 diabetes (T2D) is emerging as a serious public health concern that disproportionately affects racial/ethnic minority youth from low-socioeconomic, underserved communities [1, 2•]. Incidence has been projected to increase 4.8% annually, with the greatest rate of increase among girls from historically disadvantaged racial/ This article is part of the Topical Collection on Pediatric Type 2 and Monogenic Diabetes * Lauren D. Gulley [email protected] Lauren B. Shomaker [email protected] 1
Department of Human Development and Family Studies, College of Health and Human Sciences, Colorado State University, 1570 Campus Delivery, Fort Collins, CO 80523, USA
2
Section of Endocrinology, Department of Pediatrics, University of Colorado School of Medicine/Anschutz Medical Campus and Children’s Hospital Colorado, 13123 E 16th Avenue, B265, Aurora, CO 80045, USA
3
Department of Community and Behavioral Health, Colorado School of Public Health, Aurora, CO, USA
ethnic groups, including Native American/American Indian, Hispanic/Latino, and Black/African American [2•]. As compared with adult-onset T2D, youth-onset T2D is notable for an aggressive pathophysiology, including rapid decline in β-cell functioning, significant increase in insulin resistance, and accelerated biological progression toward deleterious health complications including kidney disease, cardiovascular disease, neuropathy, and retinopathy [3–5]. Yo
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