Prevention Program May Reduce Distress, Depression in Adolescents With T1D

depressed young man leaning forward while talking to doctor
depressed young man leaning forward while talking to doctor
Investigators examined the effect of the Penn Resilience Program for type 1 diabetes on diabetes-related distress, depressive symptoms, resilience, diabetes self-management, and glycemic control in a cohort of adolescents.

A distress and depression prevention program for adolescents with type 1 diabetes (T1D) may result in substantial reduction in diabetes distress, according to a study published in Diabetes Care.

Researchers assessed the first-year outcomes of the Supporting Teens Problem Solving (STePS) study, a 3-year trial designed to compare the efficacy of a distress and depression prevention program with a diabetes education program for adolescents with T1D. In the study, 264 participants (mean age: 15.74) from 2 locations were randomly assigned to either the Penn Resilience Program or Advanced Diabetes Education. There were no significant differences in baseline characteristics or clinical differences between the groups (P <.05).

Each intervention lasted 4.5 months, with assessments conducted at baseline and at 4.5, 8, 12, and 16 months. The primary outcome of the study was diabetes distress; other outcomes included depressive symptoms, resilience, diabetes self-management, and glycemic control.

Multiple questionnaires and blood sample collections were used to measure outcomes. At baseline, the researchers discovered no difference between groups for any of the outcome variables (P >.05). For resilience, diabetes management, and glycemic control, values were found to be generally stable over time.

As for depressive symptoms and diabetes distress, the researchers did note significant change over time. Compared with those in the Advanced Diabetes Education group, participants exposed to the Penn Resilience Program experienced greater total reduction in diabetes distress 1 year after treatment (P <.05), as well as a faster rate of reduction (P =.066). Depressive symptoms and glycated hemoglobin (HbA1c) values remained stable in all groups.

The researchers noted several limitations to their study. Its preventive nature meant that a number of participants were excluded if they were experiencing or had previously experienced elevated depressive symptoms or received treatment for depression. As such, it is unclear whether this intervention would be beneficial to a wider population.

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Despite this and other limitations, the researchers concluded, “Overall, this research demonstrates that preventing a common problem facing adolescents with T1D is possible.”


Hood KK, Iturralde E, Rausch J, Weissberg-Benchell J. Preventing diabetes distress in adolescents with type 1 diabetes: results one year after participation in the STePS program [published online June 19, 2018]. Diabetes Care. doi: 10.2337/dc17-2556