BACKGROUND Evidence is lacking on the risk of suicide-related behaviors (suicidal ideation, suicide attempt, suicide death) in youth with type 1 diabetes (T1D). PURPOSE We aimed to 1) determine the prevalence of suicidal ideation, suicide attempts, and suicide deaths in adolescents and young adults (AYA) with T1D aged 10–24 years; 2) compare suicide-related behavior prevalence in youth with and without T1D; and 3) identify factors associated with suicide-related behaviors. DATA SOURCES A systematic search was conducted in MEDLINE, Embase, and PsycInfo up to 3 September 2023. STUDY SELECTION We included observational studies where investigators reported the prevalence of suicide-related behaviors among AYA aged 10–24 years with T1D. DATA EXTRACTION We collected data on study characteristics, data on prevalence of suicide-related behaviors, and data on associated factors. DATA SYNTHESIS We included 31 studies. In AYA with versus without T1D, pooled prevalence of suicidal ideation was 15.4% (95% CI 10.0–21.7; n = 18 studies) vs. 11.5% (0.4–33.3; n = 4), respectively, and suicide attempts 3.5% (1.3–6.7; n = 8) vs. 2.0% (0.0–6.4; n = 5). Prevalence of suicide deaths ranged from 0.04% to 4.4% among youth with T1D. Difficulties with T1D self-management were frequently reported to be associated with higher rates of suicide-related behaviors. However, findings on the association of glycemic levels and suicide-related behaviors were inconsistent. LIMITATIONS There was a considerable level of heterogeneity in meta-analysis of both suicidal ideation and suicide attempts. CONCLUSIONS Suicidal ideation and suicide attempts are prevalent in AYA with T1D. Current evidence does not suggest that these rates are higher among AYA with T1D than rates among those without.

中文翻译：

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患有 1 型糖尿病的青少年和年轻人的自杀意念、自杀未遂和自杀死亡：系统评价和荟萃分析


背景 缺乏关于 1 型糖尿病 （T1D） 青少年自杀相关行为（自杀意念、自杀未遂、自杀死亡）风险的证据。目的 我们的目标是 1） 确定 10-24 岁 T1D 青少年和年轻人 （AYA） 的自杀意念、自杀未遂和自杀死亡的患病率;2） 比较患有和不患有 T1D 的青少年的自杀相关行为患病率;3） 确定与自杀相关行为相关的因素。数据来源 在 MEDLINE、Embase 和 PsycInfo 中进行了截至 2023 年 9 月 3 日的系统检索。研究选择 我们纳入了观察性研究，研究人员报告了 10-24 岁的 T1D 患者 AYA 自杀相关行为的患病率。资料提取 我们收集了有关研究特征、自杀相关行为患病率的数据以及有关相关因素的数据。数据综合 我们纳入了 31 项研究。在有 T1D 与无 T1D 的 AYA 中，自杀意念的合并患病率分别为 15.4% （95% CI 10.0-21.7;n = 18 项研究） vs. 11.5% （0.4-33.3;n = 4），自杀未遂分别为 3.5% （1.3-6.7;n = 8） vs. 2.0% （0.0-6.4;n = 5）。患有 T0.04D 的青少年自杀死亡的患病率从 4.4% 到 1% 不等。据报道，T1D 自我管理困难与自杀相关行为的发生率较高有关。然而，关于血糖水平与自杀相关行为关联的研究结果并不一致。局限性 自杀意念和自杀未遂的荟萃分析存在相当大的异质性。结论 自杀意念和自杀未遂在 T1D 的 AYA 中普遍存在。目前的证据并未表明 T1D 患者 AYA 的发生率高于无 T1D 患者的发生率。