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压力对2型糖尿病管理的影响。

Impact of Stress on Type 2 Diabetes Mellitus Management.

作者信息

Vasanth R, Ganesh Aparna, Shanker R

机构信息

Department of Psychiatry, Sri Muthukumaran Medical College, Hospital and Research Institute, Chennai, India.

出版信息

Psychiatr Danub. 2017 Sep;29(Suppl 3):416-421.

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) is one among the major health and socioeconomic problems worldwide. It is, however, not a somatic illness for which just symptomatic treatment will suffice. Stress is an important factor in not only causing diabetes onset or exacerbation, but also in hampering proper treatment by interfering with the treatment adherence of patients. Hence, it becomes important for physicians to acquaint themselves with the effects of stress on T2DM in order to ensure proper treatment of the latter.

OBJECTIVE

Documentation of effect of stress on the management of T2DM.

SUBJECTS AND METHODS

The research was a cross-sectional study on the patients attending Sri Muthukumaran Medical College, Hospital and Research Institute, Mangadu. A total of 400 people, who werepre-established diabetic patients of the hospital of age greater than 30 years, were chosen for the study. The stress levels of the patients were assessed with the Perceived Stress Scale (PSS) and treatment adherence using a questionnaire prepared exclusively for the study. Based on the data, a statistical relationship was framed between the degree of control (treatment adherence) and the stress levels of the patients.

RESULTS

The FBS levels were a direct reflection of the stress levels (P<0.05). Stress had a major impact on treatment adherence among the diabetic subjects: Increased levels of stress decreased the adherence (P<0.001). The glycemic index (HbA level) was found to be linked to both treatment adherence and stress. Increased adherence kept it at bay (P<0.05) while stress proved abysmal to glycemic control.

CONCLUSION

T2DM is the result of an interplay between various factors; environmental, psychiatric and somatic. Hence, a holistic treatment approach is required, one that involves stress management, education and mental health awareness along with pharmacological treatment, to fully control the disease.

摘要

背景

2型糖尿病(T2DM)是全球主要的健康和社会经济问题之一。然而,它并非一种仅进行对症治疗就足够的躯体疾病。压力不仅是导致糖尿病发病或加重的重要因素,还会通过干扰患者的治疗依从性来阻碍恰当治疗。因此,医生了解压力对T2DM的影响对于确保对后者的恰当治疗变得至关重要。

目的

记录压力对T2DM管理的影响。

对象与方法

该研究是对在曼加杜的斯里·穆图库马兰医学院医院及研究所就诊的患者进行的横断面研究。总共选取了400名年龄大于30岁的该医院已确诊糖尿病患者作为研究对象。使用感知压力量表(PSS)评估患者的压力水平,并通过专门为该研究编制的问卷评估治疗依从性。基于这些数据,构建了患者的控制程度(治疗依从性)与压力水平之间的统计关系。

结果

空腹血糖(FBS)水平直接反映压力水平(P<0.05)。压力对糖尿病患者的治疗依从性有重大影响:压力水平升高会降低依从性(P<0.001)。发现糖化血红蛋白(HbA)水平与治疗依从性和压力均有关联。依从性提高可使其得到控制(P<0.05),而压力对血糖控制极为不利。

结论

T2DM是多种因素相互作用的结果;包括环境、精神和躯体因素。因此,需要一种整体治疗方法,即一种将压力管理、教育和心理健康意识与药物治疗相结合的方法,以全面控制该疾病。

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