Year of Publication


Degree Name

Doctor of Nursing Practice

Committee Chair

Dr. Leslie Scott

Clinical Mentor

Dr. Elleanor Gray Vogt

Committee Member

Dr. Morgan Chojnacki


BACKGROUND: Children and adolescents with type 1 diabetes (T1DM) can encounter a variety of factors that affect proper management of their diabetes, including mental health. Youth with diabetes have significantly higher rates of depression, anxiety, and mental health problems compared to the general population. Anxiety is especially prevalent. PURPOSE: The objective of this project was to evaluate anxiety screening of children and adolescents with T1DM during their routine diabetes visits. Specifically, to assess for any trends in anxiety levels and patient characteristics including demographics, insulin regimen and A1C levels. METHODS: A cross- sectional, retrospective review of ambulatory electronic health records (AEHR) was conducted in the Pediatric Diabetes Clinic at the Barnstable Brown Diabetes Center (BBDC), University of Kentucky in Lexington, Kentucky. Records from October 1, 2019 to September 20, 2020 were evaluated for utilization of the GAD-7 screening tool in children and adolescents with T1DM during routine follow-up diabetes care. Patients from these records were on insulin therapy and had been seen for routine, follow-up diabetes care. RESULTS: Overall, it was found that the majority of adolescents screened were anxious. Statistically significant findings in association with GAD-7 scores were found related to sex, years with a diabetes diagnosis and insulin regimen. Females with T1DM were found to have higher GAD-7 scores compared to males with T1DM. Children and adolescents who have been diagnosed longer and those on insulin pump therapy were less anxious than those on multiple daily injection (MDI) therapy or shorter duration of T1DM. CONCLUSIONS: A majority of children and adolescents with T1DM screened for anxiety during routine follow-up of diabetes care were anxious. Findings support a need for increased awareness of anxiety in the T1DM adolescent population. A need for universal anxiety screening and interdisciplinary management is also supported.