Lee Hyeon-Joo, Chapa Deborah, Kao Chi-Wen, Jones Deborah, Kapustin Jane, Smith Jamie, Krichten Cathy, Donner Thomas, Thomas Sue A, Friedmann Erika
University of Maryland School of Nursing, Baltimore, MD 21201, USA.
J Am Acad Nurse Pract. 2009 Apr;21(4):214-24. doi: 10.1111/j.1745-7599.2009.00396.x.
The purpose of this article is to evaluate the contributions of diabetic complications to depression beyond the contributions of demographic characteristics in patients with type 2 diabetes. Further, this article evaluates the contributions of diabetic complications, depression, and quality of life to A1C (also know as HbA1c) beyond the contributions of demographic characteristics in individuals with type 2 diabetes.
A cross-sectional survey of 55 individuals with type 2 diabetes attending an inner city diabetes specialty clinic. Patients completed the Beck Depression Inventory - II, the Inventory of Depressive Symptomatology Self-Report, the Medical Outcome Study Short Form-36, and a demographic questionnaire. A1C and diabetes-related comorbidities were obtained from the patients' medical records.
Being younger and female were associated with depression in individuals with type 2 diabetes. After controlling for age and gender, neuropathy tended to add to the prediction of depression; other comorbidities did not. Being black was associated with poor diabetic control (A1C > 7). After controlling for race, neuropathy and retinopathy predicted poor diabetes control and depression tended to predict poor diabetes control.
Given the high prevalence of depression, the relationship of depression with poor diabetic self-care and medication adherence, and the increased cost of treatment for patients with depression among individuals with type 2 diabetes, assessment of depression is crucial. Further research is needed to establish effective treatment of depression and its effect on glycemic control in patients with type 2 diabetes.
本文旨在评估糖尿病并发症对2型糖尿病患者抑郁症的影响，这一影响超出人口统计学特征的影响。此外，本文还评估糖尿病并发症、抑郁症和生活质量对糖化血红蛋白（也称为HbA1c）的影响，这一影响超出2型糖尿病患者人口统计学特征的影响。
对一家市中心糖尿病专科诊所的55名2型糖尿病患者进行的横断面调查。患者完成了贝克抑郁量表第二版、抑郁症状自评量表、医学结局研究简表36项，以及一份人口统计学调查问卷。糖化血红蛋白和糖尿病相关合并症从患者的病历中获取。
在2型糖尿病患者中，年轻和女性与抑郁症相关。在控制年龄和性别后，神经病变倾向于增加对抑郁症的预测；其他合并症则不然。黑人与糖尿病控制不佳（糖化血红蛋白>7）相关。在控制种族后，神经病变和视网膜病变预示着糖尿病控制不佳，而抑郁症倾向于预示糖尿病控制不佳。
鉴于抑郁症的高患病率、抑郁症与糖尿病自我护理和药物依从性差的关系，以及2型糖尿病患者中抑郁症患者治疗成本的增加，抑郁症评估至关重要。需要进一步研究以确立2型糖尿病患者抑郁症的有效治疗方法及其对血糖控制的影响。
