Poor prognosis of young adults with type 1 diabetes - A longitudinal study
Poor prognosis of young adults with type 1 diabetes - A longitudinal study
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DOI：
10.2337/diacare.26.4.1052
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发表时间：
2003-04-01
期刊：
影响因子：
16.2
通讯作者：
Neil, HAW
中科院分区：
文献类型：
--
作者：
Bryden, KS;Dunger, DB;Neil, HAW
为了确定早期行为和心理因素对儿童期或初发性1型糖尿病的年轻人后期结果的作用，我们对从英国牛津的年轻人糖尿病门诊登记处招募的患者进行了一项纵向队列研究。共有113名年龄在17-25岁的个体（51名男性受试者）完成了评估，87名（77%）作为老年人（28-37岁）再次接受了采访。对血糖控制（HbA 1c）和并发症进行纵向评估。心理状态在基线进行了评估，使用目前的状态检查和自我报告的症状清单，与相应的面试时间表管理follow-up.Results-There是没有显着改善基线和随访之间的平均HbA（1c）水平（8：5对8.6%的男性，9.3对8.7%的女性）。在11年期间，患有严重并发症（增生前或激光治疗的视网膜病变、蛋白尿或更严重的肾脏疾病、周围神经病变和自主神经病变）的个体比例从3%增加到37%。女性比男性更容易发生多种并发症（23 vs. 6%，差异17%，95% CI 4- 29%，P=0.02）。精神疾病从16%增加到28%（随访时男性为20%，女性为36%，差异NS），8%的患者在两次评估时均患有精神疾病。基线精神症状评分可预测随访评分（P=0.32，SE [beta] 0.12，P=0.008，95%CI 0.09-0.56）和糖尿病酮症酸中毒的复发入院（比值比9.1，95%CI 2.9-28.6，P
Objective-To determine the role of early behavioral and psychological factors on later outcomes in young adults with childhood- or adolescent-onset type 1 diabetes.Research Design and Methods-We conducted a longitudinal cohort study of patients recruited from the register of the young adult outpatient diabetes clinic, Oxford, U.K. A total of 113 individuals (51 male subjects) aged 17-25 years completed assessments, and 87 (77%) were reinterviewed as older adults (aged 28-37 years). Longitudinal assessments were made of glycemic control (HbA(1c)) and complications. Psychological state at baseline was assessed using the Present State Examination and self-report Symptom Checklist, with corresponding interview schedules administered at follow-up.Results-There was no significant improvement between baseline and follow-up in mean HbA(1c) levels (8:5 vs. 8.6% in men, 9.3 vs. 8.7% in women). The proportion of individuals with serious complications (preproliferative or laser-treated retinopathy, proteinuria or more severe renal disease, peripheral neuropathy, and autonomic neuropathy) increased from 3-37% during the 11-year period. Women were more likely than men to have multiple complications (23 vs. 6%, difference 17%, 95% CI 4-29%, P=0.02). Psychiatric disorders increased from 16 to 28% (20% in men, 36% in women at follow-up, difference NS), and 8% had psychiatric disorders at both assessments. Baseline psychiatric symptom scores predicted follow-up scores (P=0.32, SE [beta] 0.12, P=0.008, 95% CI 0.09-0.56) and recurrent admissions with diabetic ketoacidosis (odds ratio 9.1, 95% CI 2.9-28.6, P