SAT-617 Impact of initial mental health status on clinical outcomes in pediatric diabetes patients

Abstract Disclosure: J. Han: None. M. Yang: None. H. Lee: None. D. Ha: None. H. Kim: None. H. Yoo: None. J. Han: None. J. Kim: None. Background: Psychiatric conditions, such as depression, anxiety disorders, and eating disorders, are prevalent among children and adolescents with type 1 (T1D) and type 2 diabetes mellitus (T2D), which negatively impact diabetes management. Specifically, elevated depressive symptom scores have been linked to poor glycemic control. This study aimed to assess the impact of initial mental health status on clinical outcomes by conducting mental health screenings at diagnosis and comparing clinical outcomes based on screening results. Methods: Childhood-onset (<18 years) patients with T1D and T2D diagnosed between 2019 and 2023 at Seoul National University Bundang Hospital were included. Mental health screening was conducted within one month of diagnosis, and patients were followed for at least one year. Screening tools included the Eating Disorder Inventory-2 (EDI-2; limited to three subscales), the Children’s Depression Inventory (CDI), and the Child Behavior Checklist for ages 6-18 (CBCL 6-18). Patients were categorized into two groups: those with two or more positive findings (top 20% scores of each EDI-2 subscale) and those with all negative findings. Poor glycemic control was defined as glycated hemoglobin (HbA1c) ≥ 6.5% one year after diagnosis. Logistic regression analysis was performed to compare proportions. Results: The study population comprised 32 patients (56.1%) with T1D and 25 (43.9%) with T2D. The mean age at diagnosis was 12.9 ± 3.14 years, with 31 (54.4%) males. Poor glycemic control was observed in 17 patients (29.8%). Females exhibited higher rates of poor glycemic control compared to males (46.2% vs. 16.1%; p = 0.014). Father's educational level was significantly associated with poor glycemic control (p = 0.016), while no associations were found with type of diabetes, age at diagnosis, economic status, baseline HbA1c, BMI, the occurrence of diabetic ketoacidosis or severe hypoglycemia, and mothers' education level. Among the CBCL 6-18 subscales, the somatic problem subscale was significantly associated with poor glycemic control (OR 16.32; p = 0.020), whereas other subscales showed no significant associations. Patients with two or more positive findings (n = 10, 17.5%) exhibited a significantly higher risk of poor glycemic control (OR 9.6; p = 0.040) after adjusting for sex and father’s education level. Conclusion: Psychiatric conditions identified through mental health screening at diagnosis were associated with an increased risk of poor glycemic control in pediatric diabetes patients. These findings underscore the importance of addressing psychiatric comorbidities to optimize diabetes management in pediatric population. Further research is required to elucidate the underlying mechanisms of this association and to develop specialized mental health screening tools tailored for children and adolescents with diabetes. Presentation: Saturday, July 12, 2025