Ducat Lee, Rubenstein Arthur, Philipson Louis H, Anderson Barbara J
The Mental Health Issues of Diabetes Foundation, Philadelphia, PA.
Division of Endocrinology, Diabetes and Metabolism, Raymond and Ruth Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA.
Diabetes Care. 2015 Feb;38(2):333-8. doi: 10.2337/dc14-1383.
Individuals with type 1 diabetes are at increased risk for depression, anxiety disorder, and eating disorder diagnoses. People with type 1 diabetes are also at risk for subclinical levels of diabetes distress and anxiety. These mental/behavioral health comorbidities of diabetes are associated with poor adherence to treatment and poor glycemic control, thus increasing the risk for serious short- and long-term physical complications, which can result in blindness, amputations, stroke, cognitive decline, decreased quality of life, as well as premature death. When mental health comorbidities of diabetes are not diagnosed and treated, the financial cost to society and health care systems is catastrophic, and the human suffering that results is profound. This review summarizes state-of-the-art presentations and working group scholarly reports from the Mental Health Issues of Diabetes Conference (7-8 October 2013, Philadelphia, PA), which included stakeholders from the National Institutes of Health, people living with type 1 diabetes and their families, diabetes consumer advocacy groups, the insurance industry, as well as psychologists, psychiatrists, endocrinologists, and nurse practitioners who are all nationally and internationally recognized experts in type 1 diabetes research and care. At this landmark conference current evidence for the incidence and the consequences of mental health problems in type 1 diabetes was presented, supporting the integration of mental health screening and mental health care into routine diabetes medical care. Future research directions were recommended to establish the efficacy and cost-effectiveness of paradigms of diabetes care in which physical and mental health care are both priorities.
1型糖尿病患者被诊断出患有抑郁症、焦虑症和饮食失调症的风险增加。1型糖尿病患者还存在糖尿病困扰和焦虑的亚临床水平风险。糖尿病的这些精神/行为健康合并症与治疗依从性差和血糖控制不佳有关，从而增加了严重短期和长期身体并发症的风险，这些并发症可能导致失明、截肢、中风、认知能力下降、生活质量下降以及过早死亡。当糖尿病的精神健康合并症未被诊断和治疗时，对社会和医疗保健系统的经济成本是灾难性的，所导致的人类痛苦是巨大的。本综述总结了糖尿病心理健康问题会议（2013年10月7 - 8日，宾夕法尼亚州费城）的最新报告和工作组学术报告，其中包括来自美国国立卫生研究院的利益相关者、1型糖尿病患者及其家人、糖尿病消费者权益倡导组织、保险业，以及心理学家、精神科医生、内分泌学家和执业护士，他们都是1型糖尿病研究和护理领域在国内和国际上公认的专家。在这个具有里程碑意义的会议上，展示了1型糖尿病患者心理健康问题的发生率和后果的现有证据，支持将心理健康筛查和心理保健纳入常规糖尿病医疗护理。建议未来的研究方向是确立身心健康护理均为优先事项的糖尿病护理模式的有效性和成本效益。
