Introduction and Objective: To determine the association between the combined presence of depression and distress and relevant metabolic outcomes in Latin American children with T1DM. Methods: A cross-sectional study (January-August 2025) was conducted in 11 pediatric diabetes centers in Argentina and Chile. Participants were children aged 8-17 years with T1DM duration ≥1 year. Depressive symptoms were assessed using the CES-D (0-60; depression ≥16), and distress with the PAID (0-80; distress ≥40). Results: Of the 244 enrolled participants (50% female), the median age was 13.4 years (IQR 11.3-15.0), and the median duration of diabetes was 4.4 years (IQR 3.1-6.8). The latest HbA1c was 8.3% (IQR 7.2-9.5) and 8.0% at year 2 (IQR 7.2-9.3). The agreement between high CES-D and high PAID was fair (Phi = 0.39). CES-D and PAID were significantly correlated (r = 0.66, p 0.01). However, the agreement between high CES-D and high PAID was fair (Phi = 0.39) (Figure). In multivariate logistic regression, the combined presence of high CES-D and high PAID scores was independently associated with higher HbA1c (OR 1.4; 95% CI 1.1-1.7) and DKA episodes (OR 2.4; 95% CI 1.1-5.5), adjusted for confounding variables. Conclusion: In Latin American children with T1DM, the combined presence of distress and depressive symptoms was associated with poorer metabolic control. The agreement between both scores was fair, indicating limited overlap and suggesting that each captures a distinct dimension of psychosocial burden. Disclosure V. Hirschler: None.
Hirschler et al. (Fri,) studied this question.