CBT Applications for Youth With Type 1 Diabetes

Abstract

Youth diagnosed with Type 1 Diabetes are at higher risk for psychological comorbidities such as anxiety and depression than the general population. Disease-related psychological distress including fear of hypoglycemia contributes to poor adherence to youths' medical regimes and glycemic control. Poorly managed Type 1 Diabetes often leads to adverse health outcomes such as ketoacidosis, vision impairment, and sometimes death. Cognitive-behavioral therapy is a promising method to improve health outcomes and psychological functioning in youth with Type 1 Diabetes. Accordingly, this article offers a brief overview of Type 1 Diabetes as well as examining the role of fear of hypoglycemia and disease-related anxieties in pediatric patients. Additionally, various obstacles to medical adherence and the impact of family conflict are discussed. The clinical sequelae of Type 1 Diabetes in diverse populations and the research supporting cognitive behavioral therapy are delineated. Next, the case description illustrates the challenges for youth with Type 1 Diabetes and their families. This bench-to-bedside translation presents evidence of clinically meaningful improvements from implementing CBT with a Latino male child. Psychoeducation, relaxation training, cognitive restructuring, and behavioral experiments were deployed. Last, additional considerations for treatment were presented.