Symptoms and well-being in relation to glycemic control in type II diabetes
Symptoms and well-being in relation to glycemic control in type II diabetes
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DOI：
10.2337/diacare.19.3.204
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发表时间：
1996-03-01
期刊：
影响因子：
16.2
通讯作者：
Heine, RJ
中科院分区：
文献类型：
--
作者：
VanderDoes, FEE;DeNeeling, JND;Heine, RJ
目的：描述2型糖尿病患者血糖控制与身体症状、情绪幸福感和总体幸福感之间的横断面关系。研究设计和方法：研究人群包括188名年龄在40 - 75岁之间的II型糖尿病患者。患者接受降糖药治疗或空腹静脉血糖水平大于或等于7.8 mmol/l或HbA(1)c水平bbb6.1 %。进行多元回归分析。因变量是II型糖尿病症状检查表、情绪量表、情感平衡量表和关于总体幸福感的问题的得分。研究中的主要决定因素是HbA（1c）。此外，年龄、性别、神经质（表明有抱怨的一般倾向）、胰岛素使用和合并症也是所有分析的决定因素。其他潜在的决定因素包括低血糖症状、婚姻状况、糖尿病病程、心血管病史、血压、BMI、腰臀比、治疗负担和吸烟。这些潜在的决定因素都不需要包括在内，以纠正HbA（1c）和幸福评分之间关系的混淆。结果：较高的HbA水平与较高的症状评分（总分、高血糖评分和神经性评分）、较差的情绪（总分、不愉快评分、抑郁、紧张、疲劳）和较差的总体幸福感显著相关。HbA（1c）每相差一个百分比，相对危险度在1.02 - 1.36之间变化。HbA（1c）与某些情绪状态之间的关系被神经质所改变：在不那么神经质的患者（即不太倾向于抱怨的患者）中，这种关系更为明显。结论：这些数据表明，在非低血糖HbA（1c）范围内，II型糖尿病患者更好的血糖控制与更少的身体症状、更好的情绪和更好的幸福感相关。
OBJECTIVE - To describe the cross-sectional relation between glycemic control and physical symptoms, emotional well-being, and general well-being in patients with type II diabetes.RESEARCH DESIGN AND METHODS - The study population consisted of 188 patients with type II diabetes between 40 and 75 years of age. Patients were treated with blood glucose-lowering agents or had either a fasting venous plasma glucose level greater than or equal to 7.8 mmol/l or an HbA(1)c level >6.1%. Multiple regression analyses were performed. Dependent variables were scores on the Type II Diabetes Symptom Checklist, the Profile of Mood Slates, the Affect Balance Scale, and questions regarding general well-being. The primary determinant under study was HbA(1c). In addition, age, sex, neuroticism (indicating a general tendency to complain), insulin use, and comorbidity were included as determinants in all analyses. Other potential determinants taken into consideration were hypoglycemic complaints, marital status, diabetes duration, cardiovascular history, blood pressure, BMI, waist-to-hip ratio, perceived burden of treatment, and smoking. None of these potential determinants had to be included to correct confounding of the relation between HbA(1c) and well-being scores.RESULTS - Higher HbA,, levels were significantly associated with higher symptom scores (total score, hyperglycemic score, and neuropathic score), with worse mood (total score, displeasure score, depression, tension, fatigue), and with worse general well-being. The relative risks varied between 1.02 and 1.36 for each percentage difference in HbA(1c). The relation between HbA(1c) and some mood states was modified by neuroticism: in the less neurotic patient (i.e,, one who is less inclined to complain), the relation was more evident.CONCLUSIONS - These data suggest that better glycemic control in type II diabetes is associated with fewer physical symptoms, better mood, and better well-being, in a nonhypoglycemic HbA(1c) range.