Department of Pediatrics, Institute of Clin Sciences, Sahlgrenska Academy, University of Gothenburg and The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, S-416 85 Gothenburg, Sweden.
Incentive, Holte Stationsvej, 14, 1., 2840 Holte, Denmark.
Pediatr Diabetes. 2017 Nov;18(7):651-659. doi: 10.1111/pedi.12478. Epub 2016 Dec 22.
To examine the relationship between diabetes distress and gender, and the association with glycemic control, social support, health behaviors, and socio-economic status.
All adolescents, aged 15 to 18 years, in the national, pediatric diabetes registry SWEDIABKIDS with type 1 diabetes were invited to complete an online questionnaire. A total of 2112 teenagers were identified.
453 complete responses were valid for analyses. Young women scored significantly higher on the distress-screening instrument DDS-2. Almost half of the female respondents exhibited moderate to severe diabetes distress-more than twice the proportion than among male respondents (44% vs 19%). Females reported twice as high scores on the fear of hypoglycemia scale (P < 0.0001) and had a higher HbA1c value than males (P < 0.0001). Gender was highly correlated with distress level even when controlling for multiple factors that may affect distress (parameter = 0.4, P = 0.0003). Particular social problems were highly significant, that is, those who trust that their parents can handle their diabetes when necessary were significantly less distressed than others (P = 0.018). Higher HbA1c levels were associated with higher distress scores (P = 0.0005 [female], P = 0.0487 [male]).
Diabetes-related distress is a great burden for adolescents living with diabetes. Actively involved family and friends may reduce diabetes distress, but female adolescents appear to be particularly vulnerable and may need extra focus and support. Our findings indicate that pediatric diabetes teams working with teenagers must intensify the care during this vulnerable period of life in order to reduce the risk of both psychological and vascular complications in young adults.
研究糖尿病困扰与性别之间的关系，并探讨其与血糖控制、社会支持、健康行为和社会经济地位的关联。
所有年龄在 15 至 18 岁之间的、参加全国性儿科糖尿病登记处 SWEDIABKIDS 的 1 型糖尿病青少年，均被邀请完成在线问卷调查。共确定了 2112 名青少年。
2112 名青少年中，有 453 名完整回复的问卷有效，可用于分析。女性青少年在困扰筛查工具 DDS-2 上的得分明显更高。几乎一半的女性受访者表现出中度至重度糖尿病困扰，这一比例是男性受访者的两倍多（44%比 19%）。女性在低血糖恐惧量表上的得分高出两倍（P<0.0001），HbA1c 值也高于男性（P<0.0001）。即使控制了可能影响困扰的多个因素，性别与困扰水平高度相关（参数 = 0.4，P = 0.0003）。特定的社会问题高度显著，例如，那些认为父母在必要时能够处理自己的糖尿病的人，其困扰程度明显低于其他人（P = 0.018）。HbA1c 水平越高，困扰评分也越高（P = 0.0005[女性]，P = 0.0487[男性]）。
糖尿病相关困扰是糖尿病青少年的沉重负担。积极参与的家人和朋友可能会减轻糖尿病困扰，但女性青少年似乎特别脆弱，可能需要特别关注和支持。我们的研究结果表明，与青少年一起工作的儿科糖尿病团队必须在这个脆弱的生命阶段加强护理，以降低青少年出现心理和血管并发症的风险。
