Wang DY, Yuan MY, Zhi H. Comorbid depression and glycemic instability in adolescent type 1 diabetes: Clinical insights into suicide risk. World J Psychiatry 2026; 16(4): 117207 [DOI: 10.5498/wjp.v16.i4.117207]
Corresponding Author of This Article
Dong-Yang Wang, PhD, Associate Professor, Department of Nursing, The Third People’s Hospital of Henan Province, No. 346 Funiu Road, Zhengzhou 450000, Henan Province, China. wangdongyang1994@gmail.com
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Psychology
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Minireviews
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Apr 19, 2026 (publication date) through Mar 30, 2026
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World Journal of Psychiatry
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2220-3206
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Wang DY, Yuan MY, Zhi H. Comorbid depression and glycemic instability in adolescent type 1 diabetes: Clinical insights into suicide risk. World J Psychiatry 2026; 16(4): 117207 [DOI: 10.5498/wjp.v16.i4.117207]
World J Psychiatry. Apr 19, 2026; 16(4): 117207 Published online Apr 19, 2026. doi: 10.5498/wjp.v16.i4.117207
Comorbid depression and glycemic instability in adolescent type 1 diabetes: Clinical insights into suicide risk
Dong-Yang Wang, Meng-Ying Yuan, Hua Zhi
Dong-Yang Wang, Department of Nursing, The Third People’s Hospital of Henan Province, Zhengzhou 450000, Henan Province, China
Meng-Ying Yuan, School of Management, Henan University of Chinese Medicine, Zhengzhou 450000, Henan Province, China
Hua Zhi, Department of Endocrinology, The Third People’s Hospital of Henan Province, Zhengzhou 450000, Henan Province, China
Co-corresponding authors: Dong-Yang Wang and Meng-Ying Yuan.
Author contributions: Wang DY and Yuan MY contribute equally to this study as co-corresponding authors; Wang DY performed the majority of the writing, prepared the figures and tables; Yuan MY and Zhi H designed the outline and coordinated the writing of the paper.
Supported by 2024 Zhengzhou Medical and Health Sector Science and Technology Innovation Guidance Plan, No. 2024YLZDJH050.
Conflict-of-interest statement: There is no conflict of interest associated with any senior author or other coauthors who contributed their efforts in this manuscript.
Corresponding author: Dong-Yang Wang, PhD, Associate Professor, Department of Nursing, The Third People’s Hospital of Henan Province, No. 346 Funiu Road, Zhengzhou 450000, Henan Province, China. wangdongyang1994@gmail.com
Received: December 2, 2025 Revised: December 29, 2025 Accepted: January 22, 2026 Published online: April 19, 2026 Processing time: 119 Days and 6.2 Hours
Abstract
Adolescents with type 1 diabetes face a disproportionately high risk of suicidal ideation, non-suicidal self-injury, and completed suicide, constituting a severe dual crisis of endocrinology and psychology. From a biopsychosocial perspective, this review critically analyzes the complex, bidirectional maladaptive feed-forward loop between major depressive disorder, diabetes distress, and glycemic dysregulation. The article elucidates the neurobiological impairments in adolescent brain development and emotional regulation driven by hyperglycemia-mediated neuroinflammation and hypothalamic-pituitary-adrenal axis dysfunction. Concurrently, it expounds on how depressive symptoms compromise treatment adherence through impaired executive function, specifically manifesting as lethal self-harm behaviors characterized by intentional insulin omission. Based on current evidence-based medicine, this review proposes an integrated stratified management strategy, emphasizing the critical distinction between diabetes distress and clinical depression, and evaluating the potential role of diabetes technologies (e.g., closed-loop systems) and psychopharmacology in mitigating suicide risk.
Core Tip: This review elucidates the lethal, bidirectional “neurotoxic cycle” connecting comorbid depression and glycemic dysregulation in adolescents with type 1 diabetes, identifying intentional insulin omission as a critical phenotype of covert self-harm. Beyond epidemiological associations, we synthesize evidence linking chronic hyperglycemia to neuroinflammatory changes in emotional regulation centers. Consequently, we advocate for a clinical paradigm shift from a singular “glucose-centric” approach to an integrated “psycho-metabolic” model, positioning routine suicide risk screening and means restriction as fundamental components of modern diabetes care.
