Sweet sins: frequency and psychiatric motivation for theft among adolescents with type 1 diabetes

Background: Behavioral problems are an issue among adolescents with type 1 diabetes (T1D). The authors hypothesize that theft, possibly because of an underlying psychiatric morbidity, may be a way of procuring sweets leading to worse glycemic control. Objective: To evaluate psychiatric morbidity and the association of theft and metabolic control among children and adolescents with T1D, using data from an interim analysis of an ongoing quality-of-life and psychiatric comorbidity study. Methods: One hundred and nine consecutively hospitalized individuals aged 8-18 years with T1D were asked about incidents of theft. The data on psychiatric morbidity were taken from an ongoing longitudinal study using semi-structured diagnostic interview (KSADS-PL). Results: Overall, 10 children (9%) reported that they had committed theft. Primary motivation for theft was reported as either direct or indirect gain of sweets. Patients who admitted to theft were more likely to have worse metabolic control expressed by glycated hemoglobin (HbA1c) [10.4% (interquartile range 9.8-11.8) vs. 7.7% (6.9-8.8); p < 0.0001] and higher odds of having psychiatric morbidity (odds ratio 8.2; 95% confidence interval 1.9-34.2) than their peers. In the subgroup analysis of patients with psychiatric morbidity, HbA1c was significantly higher if having committed a theft was reported [10.2% (9.4-11.9) vs. 8.1% (7.2-9.2); p < 0.001]. No significant differences in socioeconomic status, clinical factors, or rates of complications were found. Conclusions: Theft may be a factor negatively affecting metabolic control in children with T1D and underlying psychiatric co-morbidity. Psychiatric morbidity is more frequent among patients with T1D and a history of theft.