Table 1

Summary of working group recommendations

Working groupPrimary recommendations
Mental/Behavioral Health Issues of Children and Adolescents (0–18 Years) With Type 1 Diabetes and Their Families1. Mental/behavioral health issues of youth 0–18 years old must be addressed within a developmental framework.
2. Provide annual developmentally focused workshops for families that focus on the unique needs of children in specific stages of life.
3. Provide mental/behavioral health screening for youth and families at diagnosis and annually; refer for evidence-based treatments when needed.
Mental/Behavioral Health Issues of Patients With Type 1 Diabetes and Their Caregivers From Late Adolescence to Older Adulthood1. Because of the risk of depression, diabetes distress, anxiety disorders, and eating disorders, carry out preventive mental health visits at key life transition points and focus visits on adult issues, such as family conflict, fear of hypoglycemia, sexuality, finances, and insurance.
2. Promote more mental health professionals who are knowledgeable about mental/behavioral health issues of adults with diabetes.
A Model for Screening for Mental Health Comorbidities in Type 1 Diabetes1. Screening for children, adolescents, and adults with type 1 diabetes should be ongoing and incorporated into a program of “anticipatory guidance.”
2. After screening, the mental health professional should work in active collaboration with the diabetes team to ensure that patients determined to be at risk are referred for evidence-based therapies.
Future Research and Resources That Will Be Needed to Assess Paradigms of Care for Persons With Type 1 Diabetes in Which Mental and Physical Health Care Are Both Priorities1. Research designed to assess the cost-effectiveness and efficacy of integrated care should be conducted in rigorous randomized controlled trials that assess mental health outcomes, cost-effectiveness, quality of life, and patient satisfaction.
2. Research should focus on patients who are newly diagnosed and who are extensive users of medical services and other vulnerable subgroups to develop interventions tailored to unique patient subgroups.
3. National Institutes of Health and diabetes organizations should partner to fund this important research for new paradigms of diabetes care.