Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
College of Nursing, University of Illinois at Chicago, Chicago, IL, USA.
Biol Res Nurs. 2020 Apr;22(2):197-204. doi: 10.1177/1099800419898002. Epub 2020 Feb 3.
Fatigue is a pervasive and serious complaint among aging adults with type 2 diabetes. Anecdotally, hyperglycemia was thought to cause fatigue, but prior cross-sectional analyses failed to find any relationship between glucose levels and fatigue. However, study methodology may have caused this relationship to be missed. Our aim was to use concurrent and continuous data across 5 days to examine real-time momentary relationships between glucose and fatigue levels by week, day, and time of day. Additionally, we explored how these relationships differed by sex.
Participants ( = 54, 51% male, 54% non-White) wore continuous glucose monitors and wrist actigraphy into which they inputted fatigue ratings 6-8 times daily during waking hours across 5 days. Generalized estimation equation models were used to explore the relationship between glucose and fatigue when averaged by week, day, and time of day. Differences by sex were also explored.
HbA1c and baseline and real-time fatigue were higher in women than in men. Baseline HbA1c and self-reported general fatigue were unrelated. Fatigue levels averaged by day and time of day were higher in women than in men ( < .05). Glucose and fatigue were significantly related at all levels of data (weekly, daily, and time of day) in women but not men.
Our findings suggest that, when measured concurrently, glucose excursions may affect fatigue levels in women.
疲劳是 2 型糖尿病老年患者普遍存在且严重的问题。据推测，高血糖会导致疲劳，但之前的横断面分析并未发现血糖水平与疲劳之间存在任何关系。然而，研究方法可能导致这种关系被忽视。我们的目的是使用连续 5 天的实时数据，通过周、日和一天中的时间检查血糖和疲劳水平之间的实时瞬时关系。此外，我们还探讨了这种关系在性别上的差异。
参与者（= 54 人，51%为男性，54%为非白人）佩戴连续血糖监测仪和腕部动作记录仪，在 5 天的清醒时间内，每天 6-8 次输入疲劳评分。使用广义估计方程模型来探索当按周、日和一天中的时间平均时，血糖和疲劳之间的关系。还探讨了性别差异。
女性的 HbA1c 和基线及实时疲劳水平高于男性。基线 HbA1c 和自我报告的一般疲劳水平无关。女性的日间和时间平均疲劳水平高于男性（<0.05）。在女性中，血糖和疲劳在所有数据水平（每周、每日和一天中的时间）上均呈显著相关，但在男性中则无显著相关。
我们的发现表明，当同时测量时，血糖波动可能会影响女性的疲劳水平。
