Department of Family and Community Medicine, University of California, San Francisco, San Francisco, CA, USA.
Behavioural Diabetes Institute, Department of Psychiatry, University of California, San Diego, CA, USA.
Diabet Med. 2020 Jan;37(1):71-74. doi: 10.1111/dme.14082. Epub 2019 Aug 5.
To compare the effect of targeted interventions to reduce high diabetes distress among adults with Type 1 diabetes with a comparison sample of similar but untreated individuals, and to document the stability of untreated diabetes distress over time.
A total of 51 adults with Type 1 diabetes with elevated baseline diabetes distress (distress score ≥ 2.0) and HbA levels (≥ 58 mmol/mol) were identified from a longitudinal, non-intervention study, and compared with a similar sample of 51 participants in an intervention study. Both groups completed the T1-DDS diabetes distress questionnaire at baseline and 9 months.
Large and significant reductions in diabetes distress scores were recorded in the intervention group (mean ± sd change = -0.6 ± 0.6), while minimal change was found in the non-intervention group (-0.2 ± 0.6, group effect P = 0.002; effect size d = 0.67). Additional analyses using the established minimal clinically important difference for the T1-DDS showed that diabetes distress increased significantly (minimal clinically important difference ≥ 1) or persisted at high levels for 51% of participants in the non-intervention group, compared with 23.5% in the intervention group.
Our results showed that targeted interventions led to dramatic reductions in diabetes distress compared with a lack of treatment. We also conclude that elevated diabetes distress, when left unaddressed, does not resolve over time and often remains chronic. (Clinical Trials Registry no.: NCT02175732).
比较针对降低 1 型糖尿病成人高糖尿病困扰的目标干预措施与未治疗的类似个体的比较样本的效果，并记录未经治疗的糖尿病困扰随时间的稳定性。
从一项纵向非干预研究中确定了 51 名基线糖尿病困扰（困扰评分≥2.0）和 HbA 水平（≥58 mmol/mol）升高的 1 型糖尿病成人，并与干预研究中的 51 名类似参与者进行了比较。两组均在基线和 9 个月时完成 T1-DDS 糖尿病困扰问卷。
干预组的糖尿病困扰评分显著降低（平均±标准差变化=-0.6±0.6），而未干预组变化较小（-0.2±0.6，组间效应 P=0.002；效应大小 d=0.67）。使用 T1-DDS 的既定最小临床重要差异进行的额外分析表明，未经治疗组 51%的参与者的糖尿病困扰显著增加（最小临床重要差异≥1）或持续处于高水平，而干预组仅为 23.5%。
我们的结果表明，与缺乏治疗相比，针对性干预措施可显著降低糖尿病困扰。我们还得出结论，未经处理的高糖尿病困扰不会随时间解决，往往会持续存在。（临床试验注册号：NCT02175732）。
