P-375: Beyond the numbers
J Cunningham, S Krishan, K Neville, P PhanAbstract
Introduction
Diabetes distress is the emotional response arising from the relentlessness of diabetes management. It can include feeling frustrated, overwhelmed, anxious, guilty or defeated. It is an expected response from living with diabetes, not a mental health diagnosis. It is estimated that severe diabetes distress affects about one-third of adolescents with Type 1 diabetes which may lead to increased glycaemic variability and an increased severity of distress or mental illness (1).
Objectives
ISPAD Guidelines (2) recommend that psychosocial care should be integrated into routine appointments for all youth with diabetes and their families. Age-appropriate and validated assessment tools are recommended for children aged 12 and above and any psychosocial problems should be addressed upon identification. Despite this, many paediatric centres do not routinely discuss mental health or screen for psychological distress due to multiple factors.
Methods
Routine psychosocial assessments were initiated at Sydney Children’s Hospital, Randwick annual Nurse Dietitian clinics in March 2024, using a modified PAID-T screening tool (3). In the first 12 months, A total of 102 eligible patients above 12 years attended clinic and 63 of those were screened.
Results
Of those screened in the first 12 months (n=63) diabetes distress was identified in 74% (n=47), anxiety identified in 30% (n=19) and issues with weight, shape or eating were identified in 38% (n=24). 91% (n=50) reported that the Diabetes Psychosocial Assessment is beneficial. Subsequent assessments show mixed results with a decline in or improvement in diabetes distress.
Conclusions
Implementing psychosocial screening in yearly Nurse Dietitian clinics has been well received by patients and parents. Diabetes distress has been identified in over 70% of participants which shows a bigger impact than the literature suggests. Additionally, patients view psychosocial assessments to be beneficial.