November 13, 2012

Mood Disorders in Type 1 Diabetes Children


The current issue of Diabetes Care published a study that suggests the use of HbA1c level along with CDRS is a time-efficient procedure to screen for mood disorders in children with type 1 diabetes.

Thinking back to the summer of 1985 when I was diagnosed with Type 1 diabetes, I cannot recall if I had any feelings that could’ve been measured in s test. The experience of diagnosis, hospitalization, finger-stocking, insulin-dosing, injection taking was a blur. I was numb all over.

The tools of modern science compelled researchers to add the diagnosing HbA1c level to the value of the Children‘s Depression Rating Scale (CDRS). For this study, the established value of the HbA1c for a child with Type 1 diabetes is 8.7% and 9.0%. The outcome of the CDRS is added to the value of the HbA1c to flag a potential mood disorder in a child with Type 1 diabetes over a certain value.

The CDRS was developed in 1979 to diagnose depression in children. The scores in the 20 to 30 range indicates borderline depression. Well-adjusted children score between 16 to 18 on the test. Clinically  depressed children score between 22 to 49. A child who scores greater than 20 is classified as in need of close follow up to determine if he is depressed.

The “cut-off” point in the current study designated 26 for mood disorders and 30 for major depressive disorders. In other words, Type 1 diabetes is a traumatic experience by default. The filtering criteria for determining just how traumatic is offsetting the CDRS value by the HbA1c value. There is now a scale in honor of the dubious distinction of Type 1 diabetes.

If a well-adjusted kid scores between 16 to 18 on the CDRS and the acceptable range for a newly diagnosed Type 1 kid is what is considered to be ‘ borderline depression’ – is this the new normal for a kid with Type 1 diabetes?

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