What is the clinical evidence from this study?

Study design: Cohort. Population: Type 1 diabetes in pregnancy (n=249). Intervention: Type 1 diabetes vs. No diabetes. Primary outcome: Elevated depressive symptoms (PHQ-8 >5) (OR 3.5, 95% CI 1.2-10.0, p=0.02).

What does this research mean for the field?

Women with Type 1 diabetes have a more than 3-fold increased prevalence of depressive symptoms during the perinatal and postpartum periods compared to women without diabetes, and elevated diabetes distress in this population is associated with higher gestational glycemia. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to assess the prevalence of depressive symptoms and diabetes distress in women with type 1 diabetes during pregnancy and postpartum.

June 7, 2026

2143-P: Peri- and Postnatal Psychosocial Health in Women with Type 1 Diabetes: The PROMISE Study

Key Result

Pregnant and postpartum women with type 1 diabetes were 3.5 times more likely to have elevated depression scores than women without diabetes (OR 3.5; 95% CI 1.2-10.0; p=0.02).

Key Points

This study aims to assess the prevalence of depressive symptoms and diabetes distress in women with type 1 diabetes during pregnancy and postpartum.
Evaluated women once per trimester and at 4-6 weeks postpartum at four U.S. centers.
Participants completed the Patient Health Questionnaire-8 (PHQ-8) and Type 1 Diabetes Distress Survey (T1DDS).
Considered elevated scores for depressive symptoms (PHQ-8 >5) and diabetes distress (T1DDS ≥ 2.0).
Women with type 1 diabetes were 3.5 times more likely to show elevated depression scores compared to those without diabetes (95% CI 1.2-10.0, p=0.02).
19% of women with type 1 diabetes reported elevated diabetes distress in the 1st trimester, decreasing postpartum.
Women with elevated depressive symptoms had a 6.9 times higher likelihood of elevated diabetes distress scores than those without (95% CI 3.3 – 14.1, p<0.001).

Study Design

Type

Cohort (n=249)

Multicenter

Yes

Structured PICO

Do pregnant and postpartum women with Type 1 Diabetes have a higher prevalence of depressive symptoms and diabetes distress compared to women without diabetes?

Population

249 pregnant and postpartum women (213 with type 1 diabetes and 36 without) evaluated once per trimester and at 4-6 weeks postpartum for psychosocial health.

Comparator

Women without diabetes

Outcome

Prevalence of depressive symptoms (Patient Health Questionnaire-8 score >5) and diabetes distress (Type 1 Diabetes Distress Survey score ≥ 2.0)patient reported

Pregnant and postpartum women with Type 1 Diabetes have a significantly higher prevalence of depressive symptoms and diabetes distress compared to those without diabetes, which is associated with higher gestational glycemia.

Main Result

Odds Ratio: 3.5 (95% CI 1.2–10)

p-value: p=0.02

Abstract

Introduction and Objective: Type 1 diabetes (T1D) increases the risk of depression. Pregnancy can be a particularly stressful time for women with T1D, but little is known about pregnancy-related psychosocial health in this population. We report on the prevalence of depressive symptoms and diabetes distress measured by validated surveys among pregnant and postpartum women participating in a prenatal cohort study of islet autoimmunity in children who have a first-degree relative with T1D. Methods: Women were evaluated once per trimester and again at 4-6 weeks postpartum at four U.S. centers. At each visit, women completed the Patient Health Questionnaire-8 (PHQ-8) and the Type 1 Diabetes Distress Survey (T1DDS). Scores of 5 on the PHQ-8 and ≥ 2.0 on the T1DDS were considered elevated for depressive and distressed symptoms, respectively. Results: A total of 213 women with T1D and 36 women without diabetes were enrolled. The mean age was 33 ± 3 years for women with T1D and 31 ± 4 years for women without diabetes (p0.05). Women with T1D were 3.5 times more likely to have elevated depression scores than women without diabetes (95% CI 1.2-10.0, p=0.02). The prevalence of elevated diabetes distress was 19% in the 1st trimester, 12% in the 2nd trimester, 14% in the 3rd trimester, and 9% post-partum. Women with T1D who had elevated depressive symptoms during pregnancy were 6.9 times more likely to also report elevated T1DDS than women without elevated depression symptoms (95% CI 3.3 - 14.1, p0.001). Hemoglobin A1c values (HbA1c) were similar during pregnancy in women with vs without depression, but were significantly higher at all time points during pregnancy in women with vs. without elevated diabetes distress (difference 0.25 ± 0.10%, p=0.01). Conclusion: In this study, women with T1D had a more than 3-fold increased prevalence of depressive symptoms during the perinatal and postpartum periods compared with women without diabetes. Moderate or greater diabetes distress during pregnancy affects nearly 1 in 5 women with T1D and is associated with higher gestational glycemia. Disclosure F. Dong: None. K. Valdez: None. C. Chartier-Logan: None. S. Polsky: Research Support; Current; Leona M. and Harry B. Helmsley Charitable Trust, National Institute of Diabetes and Digestive and Kidney Diseases, JDRF, University of Colorado. Other - honoraria for speaking engagements; Current; Children's Diabetes Foundation. Other - honororia for speaking engagements; Current; American Diabetes Association. Board Member; Current; American College of Diabetology. Other - unpaid work to write articles for online publication; Ended; diaTribe. Research Support; Ended; Dexcom, Inc. Other - travel and lodging expenses paid for a meeting; Ended; Insulet Corporation. Other - honororia for speaking engagements; Current; AACE. C. Levy: Research Support; Current; Tandem Diabetes Care, Inc., Novo Nordisk, Abbott Diabetes, MannKind Corporation. Consultant; Current; MannKind Corporation, Tandem Diabetes Care, Inc. Research Support; Current; Deka/Sequel, Dexcom, Inc., Genti Bio. Consultant; Current; Deka/Sequel. F. Brown: Research Support; Ended; Dexcom, Inc. Other - Royalties for authorship; Current; UpToDate. E. Isganaitis: None. S. Kim: None. E. Buschur: None. J. Snell-Bergeon: None.

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