TY - JOUR
AU - E. Jetter
AU - A. Eason
AU - T. Waldmann
AU - B. Carr
A1 - 
AB - Background Youth with type 1 diabetes (T1D) experience substantially higher rates of depression, anxiety, diabetes distress, attention-deficit/hyperactivity disorder (ADHD), and disordered eating behaviors (DEB) than peers. These conditions may impair self-management and contribute to worsened glycemic outcomes.ContentWe synthesize prevalence and consequences of common comorbidities; summarize International Society for Pediatric and Adolescent Diabetes (ISPAD) and American Diabetes Association (ADA) guidance on psychosocial assessment; and appraise integrated models: co-located behavioral health, stepped care, and telehealth integration. We map barriers (workforce, workflow, stigma, fragmented communication, digital inequities) to concrete actions.SummaryPsychological morbidity and glycemic outcomes may be connected through behavioral and neuroendocrine pathways and family dynamics. Programs embedding behavioral health in pediatric diabetes care facilitate routine psychosocial screening and are associated with improved engagement and quality of life, and in some models, improved glycemic outcomes.OutlookTo close the implementation gap, teams should standardize routine psychosocial screening, embed trained mental-health professionals, use stepped-care models matching interventions to symptom severity, track referral follow-through, and leverage hybrid telehealth. Policy levers include reimbursement for integrated visits and investment in the behavioral-health workforce. The consistent associations between psychological and glycemic outcomes in youth with T1D support integrating psychosocial care as a core component of comprehensive diabetes management.
AD - University of Florida College of Medicine, Gainesville, FL, USA.; Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA.
AN - 42148554
BT - J Pediatr Endocrinol Metab
C5 - Healthcare Disparities
CP - 7
DA - 07/2026
DO - 10.1515/jpem-2026-0005
DP - NLM
ET - 20260519
IS - 7
JF - J Pediatr Endocrinol Metab
LA - eng
N2 - Background Youth with type 1 diabetes (T1D) experience substantially higher rates of depression, anxiety, diabetes distress, attention-deficit/hyperactivity disorder (ADHD), and disordered eating behaviors (DEB) than peers. These conditions may impair self-management and contribute to worsened glycemic outcomes.ContentWe synthesize prevalence and consequences of common comorbidities; summarize International Society for Pediatric and Adolescent Diabetes (ISPAD) and American Diabetes Association (ADA) guidance on psychosocial assessment; and appraise integrated models: co-located behavioral health, stepped care, and telehealth integration. We map barriers (workforce, workflow, stigma, fragmented communication, digital inequities) to concrete actions.SummaryPsychological morbidity and glycemic outcomes may be connected through behavioral and neuroendocrine pathways and family dynamics. Programs embedding behavioral health in pediatric diabetes care facilitate routine psychosocial screening and are associated with improved engagement and quality of life, and in some models, improved glycemic outcomes.OutlookTo close the implementation gap, teams should standardize routine psychosocial screening, embed trained mental-health professionals, use stepped-care models matching interventions to symptom severity, track referral follow-through, and leverage hybrid telehealth. Policy levers include reimbursement for integrated visits and investment in the behavioral-health workforce. The consistent associations between psychological and glycemic outcomes in youth with T1D support integrating psychosocial care as a core component of comprehensive diabetes management.
PY - 2026
SN - 0334-018x
SP - 629
EP - 637+
ST - Beyond A(1c): a narrative review of mental health integration in pediatric type 1 diabetes care
T1 - Beyond A(1c): a narrative review of mental health integration in pediatric type 1 diabetes care
T2 - J Pediatr Endocrinol Metab
TI - Beyond A(1c): a narrative review of mental health integration in pediatric type 1 diabetes care
U1 - Healthcare Disparities
U3 - 10.1515/jpem-2026-0005
VL - 39
VO - 0334-018x
Y1 - 2026
ER -