Patient age: a neglected factor when considering disease management in adults with type 2 diabetes.
Patient age: a neglected factor when considering disease management in adults with type 2 diabetes.
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DOI：
10.1016/j.pec.2010.10.030
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发表时间：
2011-11
影响因子：
3.5
通讯作者：
Masharani U
中科院分区：
文献类型：
--
作者：
Hessler DM;Fisher L;Mullan JT;Glasgow RE;Masharani U
2型糖尿病的平均诊断年龄正在下降。然而，由于年龄在临床研究中最常被控制，因此关于成年年龄与糖尿病相关变量的关系知之甚少。在一项以社区为基础的2型糖尿病患者（N=506）研究中，在调整了潜在的混杂变量后，我们检查了患者年龄与以下因素之间的关联：压力、抑郁、糖尿病相关的痛苦、自我效能、饮食、运动和血糖控制。然后，我们探讨了年龄在多大程度上与这些变量相互作用，使其与血糖控制相关。年轻与以下因素独立相关：更大的慢性压力和负面生活事件，更高水平的糖尿病相关痛苦，更高的抑郁情绪，吃更健康的食物和更少的锻炼，更低的糖尿病自我效能和更高的HbA 1c。相互作用表明，高压力和/或低自我效能的年轻患者比老年患者更有可能具有更高的HbA 1c水平。结果表明，年轻的2型糖尿病患者代表了一个独特的患者亚组，根据他们的发育阶段和生活背景，他们有特定的需求和健康风险。治疗方案需要针对年轻的成年患者，并且可能需要利用不同的媒介或方式（例如，社交媒体）来接触这个群体。
The average age at diagnosis for type 2 diabetes is decreasing. However, because age is most often controlled for in clinical research, little is known regarding how adult age is associated with diabetes disease-related variables. In a community based study with type 2 diabetes patients (N=506), after adjusting for potentially confounding variables, we examined associations between patients’ age and: stress, depression, diabetes-related distress, self-efficacy, diet, exercise, and glycemic control. We then explored to what extent age interacts with these variables in their association with glycemic control. Younger age was independently associated with: greater chronic stress and negative life events, higher levels of diabetes-related distress, higher depressed affect, eating healthier foods and exercising less frequently, lower diabetes self-efficacy, and higher HbA1c. Interactions showed that younger patients with high stress and/or low self-efficacy were more likely to have higher HbA1c levels than older patients. Results suggest younger adult patients with type 2 diabetes represent a unique patient subgroup with specific needs and health risks based on their developmental stage and life context. Treatment programs need to target younger adult patients and may need to utilize different media or modalities (e.g., social media) to reach this group.
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