Martyn-Nemeth Pamela, Quinn Laurie, Hacker Eileen, Park Hanjong, Kujath Amber S
Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA,
Acta Diabetol. 2014 Aug;51(4):683-6. doi: 10.1007/s00592-014-0575-1. Epub 2014 Mar 11.
The aim of this study was to determine the relationships among diabetes distress, fear of hypoglycemia, and eating styles in women with type 1 diabetes (T1DM). Fifteen women (mean age 37 ± 13.5 years) with T1DM completed surveys measuring diabetes distress, fear of hypoglycemia (FOH), and eating style. Height, weight, and A1C were obtained, and open-ended comments regarding hypoglycemic concerns and experiences were recorded. Diabetes distress was positively associated with A1C (r = .655, p = .008). High levels of external (73 %), emotional (47 %), and restrained (53 %) eating styles were reported. Emotional and external eating styles were positively associated with diabetes distress (r = .575 and r = .622; p < .05). Those with poorer glycemic control (A1C > 7 %; 53 mmol/mol) had higher levels of restrained eating behavior (F = 10.69, p = .006) and greater interpersonal distress (F = 5.916, p = .03) than those with better glycemic control (A1C < 7 %; 53 mmol/mol). A nonlinear relationship was identified between interpersonal distress and FOH (behavior subscale, p = .0383) indicating that fewer behavioral approaches were employed to avoid hypoglycemia at higher distress levels. The women in this sample were emotionally burdened by their disease. Distress was associated with eating styles linked with overeating and poor glycemic control. High levels of emotional and external eating styles may have important clinical implications for those with T1DM.
本研究旨在确定1型糖尿病(T1DM)女性患者的糖尿病困扰、低血糖恐惧和饮食方式之间的关系。15名T1DM女性患者(平均年龄37±13.5岁)完成了测量糖尿病困扰、低血糖恐惧(FOH)和饮食方式的调查问卷。获取了身高、体重和糖化血红蛋白(A1C)数据,并记录了关于低血糖担忧和经历的开放式评论。糖尿病困扰与A1C呈正相关(r = 0.655,p = 0.008)。报告显示,外部饮食(73%)、情绪性饮食(47%)和克制性饮食(53%)水平较高。情绪性饮食和外部饮食方式与糖尿病困扰呈正相关(r = 0.575和r = 0.622;p < 0.05)。血糖控制较差(A1C>7%;53 mmol/mol)的患者比血糖控制较好(A1C<7%;53 mmol/mol)的患者有更高水平的克制性饮食行为(F = 10.69,p = 0.006)和更大的人际困扰(F = 5.916,p = 0.03)。人际困扰与FOH(行为子量表,p = 0.0383)之间存在非线性关系,表明在较高困扰水平下,较少采用行为方式来避免低血糖。本样本中的女性患者因疾病而承受着情感负担。困扰与与暴饮暴食和血糖控制不佳相关的饮食方式有关。高水平的情绪性饮食和外部饮食方式可能对T1DM患者具有重要的临床意义。