Tan Maudrene L, Tan Chuen S, Griva Konstadina, Lee Yung S, Lee Jeannette, Tai E S, Khoo Eric Y, Wee Hwee-Lin
Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Department of Psychology, National University of Singapore, Singapore, Singapore.
BMC Endocr Disord. 2017 Jun 23;17(1):36. doi: 10.1186/s12902-017-0184-4.
Persistent diabetes-related distress (DRD) is experienced by patients with Type 2 Diabetes Mellitus. Knowing factors associated with persistent DRD will aid clinicians in prioritising interventions efforts.
A total of 216 patients were recruited from a tertiary hospital in Singapore, an Asian city state, and followed for 1.5 years (2011-2014). Data was collected by self-completed questionnaires assessing DRD (measured by the Problem Areas in Diabetes score) and other psychosocial aspects such as social support, presenteeism, depression, health-related quality of life (HRQoL) and excessive daytime sleepiness (EDS) at three time points. Clinical data (body-mass-index and glycated haemoglobin) was obtained from medical records. Change score was calculated for each clinical and psychosocial variable to capture changes in these variables from baseline. Generalized Linear Model with Generalized Estimating Equation method was used to assess whether baseline and change scores in clinical and psychosocial are associated with DRD over time.
Complete data was available for 73 patients, with mean age 44 (SD 12.5) years and 67% males. Persistent DRD was experienced by 21% of the patients. In the final model, baseline HRQoL (OR = 0.56, p < 0.05) and change score of EDS (OR = 1.22, p < 0.05) was significantly associated with DRD over time.
EDS might be a surrogate marker for persistent DRD and should be explored in larger samples of population to confirm the findings from this study.
2型糖尿病患者会经历持续性糖尿病相关困扰(DRD)。了解与持续性DRD相关的因素将有助于临床医生确定干预措施的优先次序。
从亚洲城市国家新加坡的一家三级医院招募了216名患者,并对其进行了1.5年(2011 - 2014年)的随访。通过自我填写问卷收集数据,在三个时间点评估DRD(用糖尿病问题领域评分衡量)以及其他心理社会方面,如社会支持、出勤主义、抑郁、健康相关生活质量(HRQoL)和日间过度嗜睡(EDS)。临床数据(体重指数和糖化血红蛋白)从医疗记录中获取。计算每个临床和心理社会变量的变化分数,以反映这些变量从基线开始的变化。使用广义估计方程方法的广义线性模型来评估临床和心理社会方面的基线和变化分数是否随时间与DRD相关。
73名患者有完整数据,平均年龄44(标准差12.5)岁,男性占67%。21%的患者经历了持续性DRD。在最终模型中,基线HRQoL(比值比=0.56,p<0.05)和EDS的变化分数(比值比=1.22,p<0.05)随时间与DRD显著相关。
EDS可能是持续性DRD的替代标志物,应在更大的人群样本中进行探索以证实本研究的结果。