Strandberg R B, Graue M, Wentzel-Larsen T, Peyrot M, Thordarson H B, Rokne B
Centre for Evidence Based Practice, Bergen University College, Bergen, Norway.
Department of Global Public Health and Primary Care, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
Diabet Med. 2015 Oct;32(10):1304-10. doi: 10.1111/dme.12781. Epub 2015 May 18.
To examine whether diabetes-specific emotional distress was related to follow-up glycaemic control in adults with Type 1 diabetes mellitus.
Adults with Type 1 diabetes mellitus completed the Diabetes Distress Scale and reported sociodemographic information when attending a clinical consultation at a university endocrinology unit. Blood samples to determine baseline HbA1c were taken during consultations. All respondents' HbA1c measurements registered from January 2009 to December 2011 were collected from medical records. The relationship between baseline diabetes-specific emotional distress and HbA1c was examined with linear mixed-effects models in 175 patients with complete data.
After controlling for confounders, baseline diabetes-specific emotional distress and glycaemic control were significantly associated (fixed-effect coefficient 0.40, P < 0.001) and the regimen-related distress subscale had the strongest association with glycaemic control (fixed-effect coefficient 0.47, P < 0.001). The two-item measure of diabetes-specific distress had a weaker but still significant association with glycaemic control (fixed-effect coefficient 0.31, P < 0.001). None of these relationships was significant after adjusting for the baseline HbA1c .
People with elevated baseline diabetes-specific emotional distress are at risk of prolonged suboptimum glycaemic control; therefore, elevated diabetes-specific emotional distress, especially regimen-related distress, might be an important marker for prolonged suboptimum glycaemic control, and might indicate a need for special attention regarding patient self-management.
探讨1型糖尿病成年患者中特定于糖尿病的情绪困扰是否与随访期血糖控制相关。
1型糖尿病成年患者在大学内分泌科进行临床会诊时，完成糖尿病困扰量表并报告社会人口学信息。会诊期间采集血样以测定基线糖化血红蛋白（HbA1c）。从医疗记录中收集所有受访者在2009年1月至2011年12月期间登记的HbA1c测量值。采用线性混合效应模型对175例有完整数据的患者，检验基线特定于糖尿病的情绪困扰与HbA1c之间的关系。
在控制混杂因素后，基线特定于糖尿病的情绪困扰与血糖控制显著相关（固定效应系数0.40，P<0.001），且与治疗方案相关的困扰子量表与血糖控制的关联最强（固定效应系数0.47，P<0.001）。特定于糖尿病困扰的两项测量指标与血糖控制的关联较弱，但仍显著（固定效应系数0.31，P<0.001）。在对基线HbA1c进行调整后，这些关系均不显著。
基线特定于糖尿病的情绪困扰升高的患者存在血糖控制长期欠佳的风险；因此，特定于糖尿病的情绪困扰升高，尤其是与治疗方案相关的困扰，可能是血糖控制长期欠佳的重要标志，可能表明在患者自我管理方面需要特别关注。
