Suicidal ideation, suicide attempts and suicide deaths in adolescents and young adults with type 1 diabetes: A systematic review and meta-analysis

Background: Evidence is lacking on the risk of suicide-related behaviours (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 behaviour prevalence in youth with and without T1D; 3) identify factors associated with suicide-related behaviours.

Data Sources: A systematic search was conducted in MEDLINE, EMBASE, and PsycINFO until September 3, 2023.

Study Selection: We included observational studies that reported the prevalence of suicide-related behaviours among AYA aged 10-24 years with T1D.

Data Extraction: We collected data on study characteristics, prevalence of suicide-related behaviours and associated factors.

Data Synthesis: We included 31 studies. In AYA with versus without T1D, pooled prevalence of suicidal ideation was 15.4% (95% confidence interval, 10.0-21.7; n=18 studies) versus 11.5% (0.4-33.3; n=4), respectively, and suicide attempts was 3.5% (1.3-6.7; n=8) versus 2.0% (0.0-6.4; n=5), respectively. Prevalence of suicide deaths ranged from 0.04% to 4.4% in youth with T1D. Difficulties with T1D self-management were frequently reported to be associated with higher rates of suicide-related behaviours. However, findings on the association of glycemic levels and suicide-related behaviours 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 in AYA with T1D compared to those without.