Abstract
Introduction: Mental health comorbidities are common in persons with type 2 diabetes (T2D). The magnitude of mental health comorbidities in youth with T2D and possible protective factors against comorbidities, remain unclear, as previous studies have not compared outcomes with population-based samples or included measures of resilience. Methods: We performed a cross-sectional analysis of 178 Indigenous youth (15 yrs IQR: 13-17 yrs) with T2D from the iCARE cohort study and 270 randomly sampled population-based controls (15-24 yrs), from the Canadian Community Health Survey - Mental Health Component. Overall positive mental health and flourishing were assessed with the Mental Health Continuum-Short Form. Depression, anxiety and severe mental illness (SMI) were assessed with the Kessler Distress Scale. Measures of resilience were assessed in youth with T2D using the 64-question Resiliency Scales for Children and Adolescents. Results: Youth with T2D, were more likely to be female (65 vs. 49%), Indigenous (96 vs. 29%), live remotely (70 vs. 26%) and within a low income neighbourhood (p<0.0001 for all characteristics). After adjusting for these differences, youth living with T2D displayed lower positive mental health (-11.0, 95%CI: -13.3, -8.6), higher distress (3.53, 95% CI: 2.76, 4.29) and higher depression scores (2.76, 95% CI: 2.19, 3.32). Youth with T2D were also more likely to have SMI (aOR: 5.81, 95% CI: 2.2, 15.4) and are less likely to be flourishing (aOR 0.27, 95%CI: 0.18, 0.41) compared to population based controls. A sense of mastery and relatedness were associated with higher positive mental health and less depression and anxiety in youth with T2D. Conclusion: Youth with T2D live with a profound degree of mental health comorbidities relative to the general population of in Manitoba, Canada. Future studies are required to address the specific mental health needs youth with T2D and determined best clinical care practices. Disclosure J. Mcgavock: None. B. Wicklow: None. E. Sellers: None. K. Kroeker: None. T. Blydt-Hansen: None. A. Dart: None. Funding Canadian Institutes of Health Research; Diabetes Canada; Research Manitoba
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