Psychosocial Aspects


Giesje Nefs, Richard Feinn, Anne-Marie Chang, Julie Wagner

Longitudinal relations of sleep quality with depressive symptoms, diabetes distress and self-efficacy in young people with type 1 diabetes. J. Psychosom. Res. 2023. 10 August 2023, 111457

Low sleep quality in young people with T1D (PWDs) is not only associated with suboptimal glycemic outcomes, lower diabetes self-management and subsequent diabetes-related complications, but also with higher depressive symptoms and diabetes-specific distress. However, not much is known yet about the temporal ordering of these associations. This study, co-authored by Giesje Nefs of Diabeter, aimed to asses if and in what order sleep is associated with depressive symptoms, diabetes distress and diabetes self-efficacy in adolescents and young adults with T1D.


This study used data from a longitudinal randomised trial aimed at improving self-monitoring of blood glucose (SMBG) among youths with T1D, using monetary rewards. PWDs were only included if they were 12-21 years old, had a T1D duration >1 year, a yearly average and most recent HbA1c >7.5%, a daily average of <4 finger pricks, had equipment for glucose data uploading and text messaging, and had a basic understanding of diabetes management. Sleep, diabetes distress, depressive symptoms and diabetes management self-efficacy were assessed using validated questionnaires.

Key findings:

  • Lower sleep quality was associated with higher depressive symptoms an lower diabetes self-efficacy, but not vice versa
  • Sleep quality was not associated with HbA1c
  • Participants in the intervention group (i.e. receiving monetary reward for more frequent SMBG and uploading of glucose values) showed higher diabetes self-efficacy and lower depressive symptoms compared with the control group


Concluding, the authors state

"To conclude, in adolescents and young adults with T1D, lower sleep quality appears to temporally precede depressive symptoms and low diabetes management self-efficacy. Given the deleterious link between suboptimal sleep and glucometrics, these findings emphasize the importance of increased attention to sleep in diabetes care. The American Diabetes Association’s Standards of Medical Care promotes regular sleep assessment, but this recommendation has not yet been widely incorporated in education and self-care routines " -

Please click here to go to the journal.

< Back

© 2023 Diabeter | Terms of Use | Privacy Statement