Psychosocial Factors Associated with Glycemic Control in Pediatric Type 1 Diabetes: Focus on Anxiety, Depression and Peer Bullying

Objective: This study aimed to evaluate the levels of depression, anxiety, and peer bullying in participants aged 11–18 years type 1 diabetes mellitus (T1DM) and to investigate the impact of these psychosocial factors on glycemic control. Methods: A cross-sectional study was conducted with 95 participants aged 11–18 years who had been diagnosed with T1DM for at least six months. Sociodemographic and clinical data were collected alongside psychological assessments using the Revised Child Anxiety and Depression Scale (RCADS) and Peer Bullying Scale (PBS). Glycemic control was evaluated via HbA1c levels. Pearson correlation, t-tests, ANOVA, multivariate logistic regression, and K-means cluster analysis were performed to examine associations. Results: Higher depression and anxiety scores were significantly associated with elevated HbA1c levels. Age, depression, and anxiety were identified as independent predictors of poor glycemic control. Although peer bullying was weakly correlated with HbA1c, no significant group differences were observed. Cluster analysis revealed that worsening glycemic control was accompanied by increasing psychological symptom severity. Conclusion: Among psychosocial factors, depression, and anxiety were found to be particularly influential in the glycemic management of children and adolescents with T1DM. These findings underscore the importance of incorporating routine psychological assessments and timely mental health support into pediatric diabetes care to optimize metabolic outcomes.