Diabetes Research Centre, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
School of Psychology, College of Medicine, Biological Sciences and Psychology, University of Leicester, Leicester, UK.
Diabet Med. 2017 Nov;34(11):1508-1520. doi: 10.1111/dme.13448. Epub 2017 Aug 31.
Psychological comorbidity, such as depression and/or diabetes-specific emotional distress (diabetes distress), is widespread in people with Type 2 diabetes and is associated with poorer treatment outcomes. Although extensive research into the prevalence of depression has been conducted, the same attention has not been given to diabetes distress. The aim of this systematic review was to determine the overall prevalence of diabetes distress in people with Type 2 diabetes.
Seven databases were searched to identify potentially relevant studies; eligible studies (adult population aged > 18 years with Type 2 diabetes and an outcome measure of diabetes distress) were selected and appraised independently by two reviewers. Multiple fixed- and random-effects meta-analyses were performed to synthesize the data; with primary analyses to determine the overall prevalence of diabetes distress in people with Type 2 diabetes, and secondary meta-analyses and meta-regression to explore the prevalence across different variables.
Fifty-five studies (n = 36 998) were included in the meta-analysis and demonstrated an overall prevalence of 36% for diabetes distress in people with Type 2 diabetes. Prevalence of diabetes distress was significantly higher in samples with a higher prevalence of comorbid depressive symptoms and a female sample majority.
Diabetes distress is a prominent issue in people with Type 2 diabetes that is associated with female gender and comorbid depressive symptoms. It is important to consider the relationship between diabetes distress and depression, and the significant overlap between conditions. Further work is needed to explore psychological comorbidity in Type 2 diabetes to better understand how best to identify and appropriately treat individuals.
心理共病，如抑郁和/或糖尿病特有的情绪困扰（糖尿病困扰），在 2 型糖尿病患者中很常见，与治疗效果较差有关。尽管已经对抑郁的患病率进行了广泛的研究，但对糖尿病困扰的关注却没有那么多。本系统评价的目的是确定 2 型糖尿病患者中糖尿病困扰的总体患病率。
搜索了 7 个数据库以确定潜在相关的研究；选择并由两名评审员独立评估符合条件的研究（年龄大于 18 岁的成年人群，患有 2 型糖尿病，且糖尿病困扰为结局测量指标）。进行了多项固定和随机效应荟萃分析以综合数据；主要分析确定 2 型糖尿病患者中糖尿病困扰的总体患病率，其次是荟萃分析和荟萃回归以探索不同变量的患病率。
55 项研究（n = 36998）纳入荟萃分析，结果显示 2 型糖尿病患者中糖尿病困扰的总体患病率为 36%。在共患抑郁症状患病率较高和女性样本占多数的样本中，糖尿病困扰的患病率明显更高。
糖尿病困扰是 2 型糖尿病患者的一个突出问题，与女性性别和共患抑郁症状有关。考虑糖尿病困扰与抑郁之间的关系以及两者之间的显著重叠非常重要。需要进一步研究 2 型糖尿病中的心理共病，以更好地了解如何最好地识别和适当治疗个体。
