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Type 1 Diabetes Mellitus and Alexithymia: A Systematic Review
Emanuele Maria Merlo1, Liam Alexander MacKenzie Myles2, Orlando Silvestro3
1Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98124 Messina, Italy.
Background:
Alexithymia has been recognised as a predictor of negative outcomes in various chronic conditions, including type 2 diabetes mellitus (T2DM). However, evidence concerning its role in type 1 diabetes mellitus (T1DM) remains limited. This systematic review aims to explore the relationship between alexithymia and T1DM.
Methods:
In June 2025, following PRISMA guidelines, a systematic review was conducted using Scopus, PubMed, and Web of Science databases. Studies specifically addressing the relationship between alexithymia and type 1 diabetes mellitus were analysed. The search strategy included the keywords "Alexithymia" AND ("Type 1 Diabetes Mellitus" OR "T1DM"). The NIH Study Quality Assessment Tool was employed to evaluate the methodological quality of the selected studies.
Results:
Fifteen studies met the inclusion criteria. The systematic analysis of the literature highlighted three dominant themes: alexithymia was found to be associated with patients' health status concerning weight and obesity, glycaemic control, and psychopathological symptoms. Moreover, alexithymia emerged as a potential predictor of adverse outcomes in T1DM self-management.
Conclusions:
Available evidence suggests that alexithymia has a clinically relevant impact on the management of T1DM. However, further research involving larger samples and longitudinal designs is needed to bridge the gap with other chronic conditions. Promoting evidence-based research in this area is aligned with the need for targeted psychological assessment, specific interventions, and improved care strategies.
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