Abstract
Purpose: To assess psychological health of people with type 1 diabetes referred for pancreas or islet transplantation and to compare SPK/PAK/IAK (simultaneous pancreas kidney/pancreas after kidney/islets after kidney) and PTA/ITA (pancreas transplant alone/islets transplant alone) candidates.
Methods: As part of standardized screening procedures, adults with type 1 diabetes referred for pancreas or islet transplantation received a (semi-standardized) clinical interview with a clinical psychologist and set of validated questionnaires. Data on demographics, diabetes related variables, lifestyle and clinical variables were derived from candidates’ medical records. Frequencies and averages of demographics, lifestyle, clinical and psychological variables were compared across SPK/PAK/IAK and PTA/ITA candidates using chi square tests for categorical data and independent sample t-tests for continuous data.
Findings: In general, PTA/ITA candidates reported higher burden of having diabetes, reflected in increased symptoms of hyper- and hypo-glycemia, struggles with self-management, increased diabetes health care use, diabetes distress and elevated HbA1c-levels. In addition, PTA/ITA candidates reported higher frequency of past and present mental health care use, DSM-diagnoses related to diabetes and use of antidepressants. Following that, concerns about psychological decompensation after transplantation were expressed more frequently for PTA/ITA candidates than for SPK/PAK/IAK candidates. Subsequently, more PTA/ITA candidates were referred for psychological support.
Conclusion: This study is the first to explore the psychological health of people referred for pancreas or islet transplantation, giving more insight in psychological symptoms and risk factors as well as the psychological vulnerability of (PTA/ITA) candidates. Future studies are needed to assess the impact of psychological health on post-transplant quality of life and outcomes.