The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes
The relationship of depressive symptoms to symptom reporting, self-care and glucose control in diabetes
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DOI：
10.1016/s0163-8343(03)00055-0
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发表时间：
2003-07-01
影响因子：
7
通讯作者：
Hirsch, IB
中科院分区：
文献类型：
--
作者：
Ciechanowski, PS;Katon, WJ;Hirsch, IB
抑郁症状在糖尿病患者中很常见，可能对自我管理和健康结果产生重大影响。在这项研究中，我们预测：1）抑郁症状与糖尿病症状负担、身体功能、糖尿病自我护理和HbA 1c水平之间存在显著相关性; 2）与2型糖尿病患者相比，1型糖尿病患者的抑郁症状与HbA 1c水平之间的相关性显著更大。这项对276名1型和199名2型糖尿病患者的横断面观察性研究在三级护理专业诊所进行。我们收集了抑郁症状、并发症、医疗合并症、糖尿病症状、糖尿病自我护理行为、身体功能和人口统计学方面的自我报告数据。根据自动化数据，我们确定了上一年的平均HbA 1c水平。我们进行了线性回归分析，以评估抑郁症状与糖尿病症状感知、糖尿病自我护理行为、身体功能和血糖控制之间的关联。在1型和2型糖尿病患者中，抑郁症状与更多的糖尿病症状报告、较差的身体功能以及较少的运动方案和饮食依从性相关。在1型糖尿病患者中，抑郁症状与HbA 1c水平之间存在显著相关性，但在2型糖尿病患者中无相关性。由于抑郁症状与糖尿病护理的临床方面（如糖尿病症状报告和糖尿病自我护理依从性）相关，因此在治疗糖尿病患者时识别抑郁症状非常重要。(C)2003年爱思唯尔公司All rights reserved.
Depressive symptoms are common among patients with diabetes and may have a significant impact on self-management and health outcomes. In this study we predicted that: 1) there would be a significant association between depressive symptoms and diabetes symptom burden, physical functioning, diabetes self-care, and HbA1c levels; and, 2) that the association between depressive symptoms and HbA1c levels would be significantly greater in type 1, as compared to type 2 diabetic patients. This cross-sectional observational study of 276 type 1 and 199 type 2 diabetes patients took place in a tertiary care specialty clinic. We collected self-reported data on depressive symptoms, complications, medical comorbidity, diabetes symptoms, diabetes self-care behaviors, physical functioning, and demographics. From automated data we determined mean HbA1c levels over the prior year. We performed linear regression analyses to assess the association between depressive symptoms and diabetes symptom perception, diabetes self-care behaviors, physical functioning, and glycemic control. Among patients with type 1 and 2 diabetes, depressive symptoms were associated with greater diabetes symptom reporting, poorer physical functioning, and less adherence to exercise regimens and diet. There was a significant association between depressive symptoms and HbA1c levels in type 1, but not type 2 diabetic patients. Because of their association with clinical aspects of diabetes care such as diabetes symptom reporting and adherence to diabetes self-care, depressive symptoms are important to recognize in treating patients with diabetes. (C) 2003 Elsevier Inc. All rights reserved.