Mental health disorders affect more than 1 in 4 pediatric patients with diabetes

Children and adolescents with diabetes presenting to emergency departments (EDs) had substantially higher rates of concomitant mental health disorders than peers without diabetes, according to a nationwide analysis of nearly 19 million pediatric ED encounters presented by Hannah Murphy, PhD, lead, analytics and insights at Vizient.

The analysis included 18,860,924 pediatric ED encounters among patients aged 2 to 17 years discharged between 2018 and 2023 across 621 continuously reporting hospitals in the Vizient clinical database. Among those encounters, 739,353 (3.9%) involved children with diabetes. Of those patients, 197,407 (26.7%) also had a documented mental health disorder, compared with 11.6% among patients without diabetes.

“In our analysis of nearly 19 million pediatric ED encounters, we found that 1 in 4 children with diabetes also had a documented mental health disorder, compared to 1 in 9 without diabetes,” Murphy said in an interview with Contemporary Pediatrics.

The study used International Classification of Diseases, Tenth Revision, Clinical Modification codes to identify type 1 and type 2 diabetes, as well as concomitant mental health disorders, including anxiety, mood, developmental, behavioral/emotional, and substance use disorders.

Mood and anxiety disorders were among the most commonly identified psychiatric conditions. ED visits among children with diabetes included mood disorders in 10.4% of encounters and anxiety disorders in 8.9% of encounters.

Murphy emphasized that the findings suggest mental health concerns should be viewed as part of routine diabetes management rather than as a separate issue.

“So this really tells us this is not a small subgroup issue. It’s a major part of pediatric diabetes care,” Murphy said. “And for many children and adolescents with diabetes, the emotional and behavioral burden is part of the disease experience itself.”

Investigators also identified marked differences in suicide-related outcomes. Among pediatric ED admissions involving diabetes and any mental health disorder, 5.6% involved suicidal ideation or suicide attempt compared with 0.5% among those without a mental health disorder.

“It doesn’t necessarily mean that every child with diabetes who also has some sort of mental health diagnosis is in crisis, but what it does mean is that pediatricians really should take this suicide risk seriously and normalize screening as part of the routine care,” Murphy said.

Murphy added that screening should include validated, age-appropriate tools assessing depression, anxiety, self-harm, and suicidal thoughts, paired with established referral pathways and follow-up systems.

Multivariable logistic regression analyses identified several factors associated with increased risk for both diabetes and mental health disorders among children with diabetes. Older adolescents, particularly those aged 15 to 17 years, had significantly higher odds of mental health disorders. Medicaid coverage and higher social vulnerability were also associated with elevated risk.

According to Murphy, these findings highlight the importance of addressing barriers to care and social determinants of health alongside medical management.

“It also means recognizing that these missed appointments or children with poor glycemic control may reflect a kind of barrier to access, rather than a lack of motivation,” she said.

The presentation also emphasized the need for integrated care models involving endocrinology, behavioral health, primary care, and social services.

“We often treat medical conditions in 1 setting and mental health disorders or mental health in another setting,” Murphy said. “But what these children really need is integrated care.”

Disclosure: Murphy reports no relevant disclosures.

Reference

Murphy H. Children with Diabetes Face Significantly Higher Mental Health Burden. Vizient; 2026:1-22.