Does Glycemic Variability Impact Mood and Quality of Life?
Does Glycemic Variability Impact Mood and Quality of Life?
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DOI：
10.1089/dia.2011.0191
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发表时间：
2012-04-01
影响因子：
5.4
通讯作者：
Strange, Poul
中科院分区：
文献类型：
--
作者：
Penckofer, Sue;Quinn, Lauretta;Strange, Poul
背景：糖尿病是一种严重影响生活质量的慢性疾病。血糖控制不佳与更多的糖尿病并发症、抑郁症和更差的生活质量有关。血糖变异性对情绪和生活质量的影响尚未研究。方法：采用描述性探索性设计。23例2型糖尿病女性患者佩戴动态血糖监测系统72 h，完成一系列问卷调查。测量包括（1）通过糖化血红蛋白和24小时平均葡萄糖显示的血糖控制，（2）通过葡萄糖读数的24小时SD显示的血糖变异性，连续总体净血糖作用（CONGA）和傅立叶统计模型，以生成平滑曲线来评估定义为“能量”的变化率，以及（3）情绪结果：糖尿病合并抑郁症患者的焦虑、愤怒情绪明显高于无抑郁症患者，生活质量明显低于无抑郁症患者。某些血糖变异性指标与情绪和生活质量相关。在调整年龄和体重后，血糖读数和CONGA测量的24小时SD与健康相关的生活质量显著相关。傅立叶模型表明，某些能量成分与抑郁，特质焦虑和整体生活质量显着相关。最后，具有较高特质焦虑的受试者往往有陡峭的葡萄糖excursions.Conclusions：数据表明，更大的血糖变异性可能与较低的生活质量和负面情绪。其意义包括在更大的样本中复制该研究，以评估血糖波动对情绪和生活质量的影响。
Background: Diabetes is a chronic condition that significantly impacts quality of life. Poor glycemic control is associated with more diabetes complications, depression, and worse quality of life. The impact of glycemic variability on mood and quality of life has not been studied.Methods: A descriptive exploratory design was used. Twenty-three women with type 2 diabetes wore a continuous glucose monitoring system for 72 h and completed a series of questionnaires. Measurements included (1) glycemic control shown by glycated hemoglobin and 24-h mean glucose, (2) glycemic variability shown by 24-h SD of the glucose readings, continuous overall net glycemic action (CONGA), and Fourier statistical models to generate smoothed curves to assess rate of change defined as "energy,'' and (3) mood (depression, anxiety, anger) and quality of life by questionnaires.Results: Women with diabetes and co-morbid depression had higher anxiety, more anger, and lower quality of life than those without depression. Certain glycemic variability measures were associated with mood and quality of life. The 24-h SD of the glucose readings and the CONGA measures were significantly associated with health-related quality of life after adjusting for age and weight. Fourier models indicated that certain energy components were significantly associated with depression, trait anxiety, and overall quality of life. Finally, subjects with higher trait anxiety tended to have steeper glucose excursions.Conclusions: Data suggest that greater glycemic variability may be associated with lower quality of life and negative moods. Implications include replication of the study in a larger sample for the assessment of blood glucose fluctuations as they impact mood and quality of life.