51-LB: Depression Scores and Suicide Attempt History Are Independently Associated with Hemoglobin A1c (HbA1c) in Adolescents and Young Adults with Type 1 Diabetes

Adolescents and young adults (AYA) with type 1 diabetes (T1D) are at an elevated risk for depression and suicide, and regular screening is an integral part of medical care. The Patient Health Questionnaire-9 Adolescent Version (PHQ-9; Johnson et al., 2002) is commonly used to screen for depression and suicide risk, and more information is needed about how ratings relate to diabetes management. The goal of this study was to quantify PHQ-9 scores, suicidal ideation (SI) in the past 2 weeks, and suicide attempt history (SAH) in AYA with T1D and to examine their relationships with HbA1c. The PHQ-9 was electronically administered to AYA with T1D (n = 759) at outpatient medical visits, and results from the PHQ-9, relevant background variables (age, sex, race, diabetes duration, BMI and systolic blood pressure) , and HbA1c values were obtained from the medical record. On average, AYA were 17.2 years old, had diabetes for 7.6 years, and had an HbA1c of 8.5%. On the PHQ-9, 72.6% scored in the normal range (0-4) , 19.9% in the subthreshold range (5-10) , and 7.5% at or above threshold (≥ 11) . SI was reported by 4.2% of the sample and 5.3% noted SAH. In linear regression models adjusted for relevant background variables, greater levels of PHQ-9 symptoms were associated with higher HbA1c (B = .06, p < .001) . When examining categories of PHQ-9 scores, those with subthreshold depressive symptoms had marginally higher, (B = .331, p =.07) , and those at or above threshold had significantly higher, HbA1c (B = .799, p =.003) . SI was not associated with HbA1c, but SAH was associated with higher HbA1c (B = 1.13, p < .001) . Notably, PHQ-9 scores (B = .05, p =.005) and SAH (B = .884, p =.007) were each independently associated with higher HbA1c after adjusting for the other. These findings highlight the importance of identifying and providing additional support for AYA with elevated PHQ-9 scores, as well as those with SAH even if current depression scores are not concerning.