Georgiades Anastasia, Zucker Nancy, Friedman Kelli E, Mosunic Christopher J, Applegate Katherine, Lane James D, Feinglos Mark N, Surwit Richard S
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Box 3842, Durham, NC 27710, USA.
Psychosom Med. 2007 Apr;69(3):235-41. doi: 10.1097/PSY.0b013e318042588d. Epub 2007 Apr 9.
To investigate if changes in depressive symptoms would be associated with changes in glycemic control over a 12-month period in patients with Type 1 and Type 2 diabetes.
Ninety (Type 1 diabetes, n = 28; Type 2 diabetes, n = 62) patients having Beck Depression Inventory (BDI) levels of >10 were enrolled in the study. Of those 90 patients, 65 patients completed a 12-week cognitive behavioral therapy intervention. BDI was assessed at baseline and thereafter biweekly during 12 months. Hemoglobin (HbA1c) and fasting blood glucose levels were assessed at baseline and at four quarterly in-hospital follow-up visits. Linear mixed-model analysis was applied to determine the effects of time and diabetes type on depressive symptoms, HbA1c levels, and fasting glucose levels.
Mean and standard deviation baseline BDI and HbA1c levels were 17.9 +/- 5.8 and 7.6 +/- 1.6, respectively, with no significant difference between patients with Type 1 and Type 2 diabetes. Mixed-model regression analysis found no difference between the groups with Type 1 and Type 2 diabetes in the within-subject effect of BDI score on HbA1c or fasting glucose levels during the study. Depressive symptoms decreased significantly (p = .0001) and similarly over a 12-month period in both patients with Type 1 and Type 2 diabetes, whereas HbA1c and fasting glucose levels did not change significantly over time in either group.
Changes in depressive symptoms were not associated with changes in HbA1c or fasting glucose levels over a 1-year period in either patients with Type 1 or Type 2 diabetes.
探讨1型和2型糖尿病患者在12个月期间抑郁症状的变化是否与血糖控制的变化相关。
90名贝克抑郁量表（BDI）评分>10的患者（1型糖尿病28例，2型糖尿病62例）纳入研究。这90名患者中，65名患者完成了为期12周的认知行为疗法干预。在基线时评估BDI，此后在12个月内每两周评估一次。在基线时以及四次季度住院随访时评估血红蛋白（HbA1c）和空腹血糖水平。应用线性混合模型分析来确定时间和糖尿病类型对抑郁症状、HbA1c水平和空腹血糖水平的影响。
BDI和HbA1c水平的平均基线值及标准差分别为17.9±5.8和7.6±1.6，1型和2型糖尿病患者之间无显著差异。混合模型回归分析发现1型和2型糖尿病组在研究期间BDI评分对HbA1c或空腹血糖水平的受试者内效应无差异。1型和2型糖尿病患者在12个月期间抑郁症状均显著下降（p = 0.0001）且下降程度相似，但两组患者HbA1c和空腹血糖水平均未随时间显著变化。
1型或2型糖尿病患者在1年期间抑郁症状的变化与HbA1c或空腹血糖水平的变化无关。
