Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Düsseldorf, Germany.
German Centre for Diabetes Research (DZD), Munich-Neuherberg, Germany.
Diabet Med. 2019 Jul;36(7):836-846. doi: 10.1111/dme.13931. Epub 2019 Mar 25.
This study aimed to determine cross-sectional relationships between diabetes distress and health-related variables, and prospective associations between diabetes distress and future glycaemic control (HbA ) and health status among young adults with early-onset Type 1 diabetes.
Data were collected from a nationwide cohort study of adults whose Type 1 diabetes onset occurred from 0 to 4 years of age during 1993-2002. Questionnaire surveys were conducted in 2012-2013 and 2015-2016 (N = 584). Diabetes distress was assessed via the Problem Areas in Diabetes (PAID) scale (0-100 points), depressive symptoms via the Patient Health Questionnaire-9 (PHQ-9) and health status via the 12-Item Short Form Health Survey (SF-12) questionnaire. Multivariable linear regression analyses were applied to cross-sectional and longitudinal data.
In the cross-sectional analyses, higher PAID scale total scores (representing higher distress levels) were observed in women than in men and in participants with more severe depressive symptoms. PAID scores were lower in individuals with better physical and mental health. A 1 mmol/mol increase in HbA was associated with a 0.28-point increase [95% confidence interval (95% CI) 0.20, 0.36] in diabetes distress. In longitudinal analyses adjusting for age, sex, socio-economic index and HbA at baseline, a 10-point higher PAID score at baseline was associated with a 1.82 mmol/mol higher HbA level (95% CI 0.43, 3.20) and a 2.48-point lower SF-12 mental health score (95% CI -3.55, -1.42) three years later.
The cross-sectional and longitudinal analyses results suggest that diabetes distress impairs health-related outcomes in young adults with early-onset diabetes.
本研究旨在确定糖尿病困扰与健康相关变量之间的横断面关系，以及糖尿病困扰与年轻起病的 1 型糖尿病患者未来血糖控制（HbA ）和健康状况之间的前瞻性关联。
数据来自于一项全国性的成年人队列研究，这些成年人的 1 型糖尿病发病年龄在 1993-2002 年期间为 0-4 岁。2012-2013 年和 2015-2016 年进行了问卷调查（N=584）。使用糖尿病困扰量表（PAID）（0-100 分）评估糖尿病困扰，使用患者健康问卷-9（PHQ-9）评估抑郁症状，使用 12 项简明健康调查量表（SF-12）评估健康状况。多变量线性回归分析用于横断面和纵向数据分析。
在横断面分析中，PAID 量表总分（代表较高的困扰水平）在女性中高于男性，在抑郁症状较严重的参与者中也较高。在身体和心理健康状况较好的个体中，PAID 评分较低。HbA 每增加 1mmol/mol，糖尿病困扰程度增加 0.28 分[95%置信区间（95%CI）0.20，0.36]。在调整年龄、性别、社会经济指数和基线 HbA 后，基线时 PAID 评分每增加 10 分，HbA 水平三年后增加 1.82mmol/mol（95%CI 0.43，3.20），SF-12 心理健康评分降低 2.48 分（95%CI -3.55，-1.42）。
横断面和纵向分析结果表明，糖尿病困扰会损害年轻起病的糖尿病患者的健康相关结局。
