There is a complex interrelationship between psychosocial outcomes and A1c in adolescents with type 1 diabetes and co-occurring anxiety symptoms, suggesting early interventions addressing the multi-directional relationship among psychosocial outcomes and A1c are critically important to improving self-care behaviors and glycemic control.
Higher hemoglobin A1c values were significantly associated with lower diabetes self-care scores in adolescents with type 1 diabetes and anxiety symptoms.
Lower diabetes self-care scores were associated with worse sleep quality in adolescents with type 1 diabetes and anxiety symptoms.
Generalized anxiety symptoms were associated with poor sleep quality.
Diabetes-specific anxiety symptoms were associated with worse diabetes-specific quality of life.
Diabetes-specific anxiety symptoms were associated with worse diabetes self-care behaviors.
Poor sleep quality was associated with worse diabetes-specific quality of life.
The study sample was a cross-sectional convenience sample of 40 adolescents with type 1 diabetes and co-occurring anxiety symptoms recruited in 2024.
This research suggests that for teenagers living with type 1 diabetes who also experience anxiety, there is a web of interconnected challenges that all influence one another. Specifically, the study found that higher blood sugar levels (measured by HbA1c) were linked to poorer diabetes self-care, that anxiety was linked to worse sleep, and that poor sleep was linked to worse quality of life. Diabetes-specific worries — anxiety focused specifically on managing diabetes — were particularly strongly linked to both poorer quality of life and worse self-care behaviors. The study enrolled 40 adolescents between ages 12 and 19 who all had at least mild anxiety symptoms, and used surveys to measure sleep quality, anxiety, self-care behaviors, and quality of life. The cross-sectional design means the data were collected at a single point in time, so the findings show associations between these factors but cannot confirm which causes which. The sample was also relatively small and mostly White, non-Hispanic, and female, which may limit how broadly the findings apply. This research suggests that treating anxiety and sleep problems in teenagers with type 1 diabetes may be just as important as focusing on blood sugar management directly, since these psychosocial factors are closely tied to self-care and glycemic control. Healthcare providers working with this population may benefit from screening for anxiety and sleep difficulties as a routine part of diabetes care, and developing interventions that address all of these interrelated challenges together rather than in isolation.
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Upload Your LabsRechenberg K, Koerner R, Nguyen T, Xie R. (2026). Anxiety and Self-Care in Adolescents with Type 1 Diabetes.. MCN. The American journal of maternal child nursing. https://doi.org/10.1097/NMC.0000000000001234