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Depression and Distress in Pediatric Type 1 Diabetes: A Latin American Multicenter Study

Valeria Hirschler1, Claudio D Gonzalez2, Amanda Benitez3

  • 1Diabetes Argentine Society, Epidemiology , Buenos Aires, Argentina.

Endocrine Connections
|August 14, 2026
PubMed

Insights

In Latin American children with type 1 diabetes mellitus (T1DM), high rates of depressive symptoms and diabetes distress were found. Their combined presence is linked to worse metabolic control and lower socioeconomic status (SES).

Area of Science:

  • Pediatric Endocrinology
  • Child Psychology
  • Diabetes Management

Background:

  • Type 1 diabetes mellitus (T1DM) in children requires ongoing management, significantly impacting quality of life.
  • Mental health comorbidities, including depressive symptoms and diabetes-related distress, are increasingly recognized in pediatric T1DM populations.
  • Understanding the interplay between mental health and metabolic control is crucial for comprehensive T1DM care.

Purpose of the Study:

  • To assess the prevalence of depressive symptoms and diabetes-related distress in Latin American children with T1DM.
  • To investigate the association between the co-occurrence of depressive symptoms and diabetes distress with metabolic outcomes.
  • To explore the relationship between these psychological factors, socioeconomic status (SES), and glycemic control (HbA1c).

Main Methods:

  • A cross-sectional study involving 244 children with T1DM from 10 centers in Argentina and Chile.
  • Depressive symptoms assessed via the Center for Epidemiologic Studies Depression Scale (CES-D); diabetes distress via Problem Areas in Diabetes (PAID).
  • Statistical analyses included Spearman correlation, Phi coefficient, and multivariable logistic regression, controlling for age, sex, and BMI.

Main Results:

  • Prevalence rates were high: 52% for depressive symptoms (CES-D ≥16) and 26.6% for diabetes distress (PAID ≥40).
  • The subgroup with both high depressive symptoms and high diabetes distress (22.5%) showed significant inverse correlation with SES and positive correlation with HbA1c.
  • Multivariable analysis revealed higher HbA1c (OR 1.34) and lower SES (OR 0.36) were independently associated with this high-symptom group.

Conclusions:

  • The combined presence of depressive symptoms and diabetes-related distress is common in Latin American children with T1DM.
  • This dual psychological burden is significantly associated with poorer metabolic control (higher HbA1c) and lower socioeconomic status.
  • Findings underscore the need for integrated mental health screening and support in pediatric T1DM management.
Abstract

Keywords:
Latin American ChildrenType 1 diabetesdiabetes distress

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