Association of Depressive Symptoms and Diabetes Distress With Severe Hypoglycemia in Adults With Type 2 Diabetes
Association of Depressive Symptoms and Diabetes Distress With Severe Hypoglycemia in Adults With Type 2 Diabetes
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DOI：
10.1016/j.jcjd.2018.11.002
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发表时间：
2019-07-01
影响因子：
2.5
通讯作者：
Johnson, Jeffrey A.
中科院分区：
文献类型：
--
作者：
Al Sayah, Fatima;Yeung, Roseanne O.;Johnson, Jeffrey A.
目的：研究成人2型糖尿病患者的抑郁症状(DS)和糖尿病相关苦恼(DD)与严重低血糖(SH)的关系。方法：采用成人2型糖尿病(N=2,040)队列研究的基线数据。采用患者健康问卷8个条目和糖尿病5个条目中的问题区域问卷分别对DS和DD进行评定。SH被定义为“在过去一年中因低血糖而叫救护车或去急诊科就诊”的积极报告。结果：受试者平均(+/-SD)年龄为+/-11岁，其中45%为女性。糖尿病的平均病程为12+/-9年；3%的人有中到重度的DS，8%的人有中到重度的DD，5%的人同时有两种症状。只有4.2%的参与者报告在过去一年中经历过SH。存在任何水平的DD(调整后OR 2.3；95%CI 1.3，3.9)或中至重度DD(2.2；1.1，4.2)与SH的风险增加相关。任何水平的DD和DS(4.3；2.5，7.3)和中到重度DD和DS(2.3；1.1，4.8)的组合与SH的风险增加相关。单纯DS(1.2；0.3，4.9)或中至重度DS(1.7；0.6，5.1)的存在与SH的风险增加无关。结论：伴有抑郁症状的2型糖尿病患者比无上述两种症状的患者更容易发生SH。(C)2018年加拿大糖尿病协会。
Objectives: To examine the association of depressive symptoms (DS) and diabetes-related distress (DD) with severe hypoglycemia (SH) in adults with type 2 diabetes.Methods: Baseline data from a cohort study of adults with type 2 diabetes (N=2,040) were used. The Patient Health Questionnaire 8-items and Problem Areas in Diabetes 5-items questionnaires were used to assess DS and DD, respectively. SH was defined as a positive report of "calling an ambulance or visiting an emergency department because of hypoglycemia in the past year." Composite dummy variables for the 2 stratification levels of DS and DD were computed and used in multivariable logistic regression analyses.Results: Participants had a mean (+/- SD) age of 64 +/- 11 years, and 45% were female. The average duration of diabetes was 12 +/- 9 years; 3% had moderate to severe DS, 8% had moderate to severe DD and 5% had moderate to severe levels of both symptoms. Only 4.2% of participants reported experiencing SH in the past year. The presence of any level of DD (adjusted OR 2.3; 95% CI 1.3, 3.9) or moderate to severe DD (2.2; 1.1, 4.2) was associated with increased risk for SH. Combinations of any levels of DD and DS (4.3; 2.5, 7.3) and moderate to severe DD and DS (2.3; 1.1, 4.8) were associated with increased risk for SH. The presence of any level of DS alone (1.2; 0.3, 4.9) or moderate to severe DS (1.7; 0.6, 5.1) was not associated with increased risk for SH.Conclusions: Patients with type 2 diabetes and symptoms of depression, but not diabetes-related distress alone, were more likely to experience SH than those without either of these symptoms. (C) 2018 Canadian Diabetes Association.