Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes.
Diabetes distress is linked with worsening diabetes management over time in adults with Type 1 diabetes.
复制标题
DOI：
10.1111/dme.13381
复制
发表时间：
2017-09
期刊：
影响因子：
--
通讯作者：
Bowyer V
中科院分区：
文献类型：
--
作者：
Hessler DM;Fisher L;Polonsky WH;Masharani U;Strycker LA;Peters AL;Blumer I;Bowyer V
确定糖尿病困扰和糖尿病管理之间的横向和纵向关联。在一项非干预性研究中，评估了224例1型糖尿病成人患者基线和9个月时的糖尿病困扰、胰岛素推注遗漏、低血糖发作和HbA 1c。在基线时，更大的痛苦与更高的HbA 1c和更大比例的错过胰岛素推注相关。纵向上，基线痛苦升高与漏服胰岛素推注增加相关，痛苦降低与HbA 1c降低相关。在补充分析中，抑郁症状或重度抑郁障碍的诊断均与错过胰岛素推注、HbA 1c或横截面或纵向分析中的低血糖发作无关。在糖尿病困扰和管理之间发现了显著的横截面和纵向关联;相反，在重度抑郁症或抑郁症状中没有发现平行关联。研究结果表明，随着时间的推移，痛苦的增加可能会导致更多的胰岛素输注失败，这表明了一个潜在的干预目标。痛苦和HbA 1c之间的协变关联指出了这些结构之间复杂且可能的交互关联。研究结果强调，需要解决的痛苦作为糖尿病管理的一个组成部分，在常规护理。
To determine the cross-sectional and longitudinal associations between diabetes distress and diabetes management. In a non-interventional study, 224 adults with Type 1 diabetes were assessed for diabetes distress, missed insulin boluses, hypoglycaemic episodes, and HbA1c at baseline and 9 months. At baseline, greater distress was associated with higher HbA1c and a greater percentage of missed insulin boluses. Longitudinally, elevated baseline distress was related to increased missed insulin boluses, and decreases in distress were associated with decreases in HbA1c. In supplementary analyses, neither depression symptoms nor a diagnosis of major depressive disorder was associated with missed insulin boluses, HbA1c or hypoglycaemic episodes in cross-sectional or longitudinal analyses. Significant cross-sectional and longitudinal associations were found between diabetes distress and management; in contrast, no parallel associations were found for major depressive disorder or depression symptoms. Findings suggest that elevated distress may lead to more missed insulin boluses over time, suggesting a potential intervention target. The covarying association between distress and HbA1c points to the complex and likely interactive associations between these constructs. Findings highlight the need to address distress as an integral part of diabetes management in routine care.
登录
查看更多内容
影响因子：
8.2
作者：
Gonzalez, J. S.;Delahanty, L. M.;Safren, S. A.;Meigs, J. B.;Grant, R. W.
通讯作者：
Grant, R. W.
影响因子：
0.5
作者：
Kroenke, K;Spitzer, RL
通讯作者：
Spitzer, RL
影响因子：
16.2
作者：
Gonzalez, Jeffrey S.;Kane, Naomi S.;Hoogendoorn, Claire J.
通讯作者：
Hoogendoorn, Claire J.
影响因子：
3.5
作者：
Weinger, K;Jacobson, AM
通讯作者：
Jacobson, AM
影响因子：
16.2
作者：
Gonzalez JS;Fisher L;Polonsky WH
通讯作者：
Polonsky WH