Department of Endocrinology, Singapore General Hospital, Singapore.
Academic Clinical Program, Division of Medicine, Singapore General Hospital, Singapore.
Diabetes Metab J. 2021 Jan;45(1):67-76. doi: 10.4093/dmj.2019.0226. Epub 2020 Jun 15.
There is little longitudinal information on psychological burden and metabolic outcomes in young adults with diabetes (YAD) in Asia. We aimed to evaluate the association between psychological status and glycemia at baseline and 2 years following transition in a cohort of YAD in Singapore.
Subjects with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), aged 17 to 25 years, were recruited from the YAD clinic in Singapore General Hospital. The Hospital Anxiety and Depression and Problem Areas for Diabetes scales were administered at transition (baseline) and at 18 to 24 months. Glycosylated hemoglobin (HbA1c) assessed during routine visits was tracked longitudinally.
A total of 98 T1DM (74.8%) and 33 T2DM (25.2%) subjects were recruited between January 2011 and November 2017. At baseline, mean HbA1c was 8.6%±1.7%. Only 26.0% achieved HbA1c of ≤7.5% and 16.8% achieved HbA1c of <7%. At baseline, prevalence of anxiety was 29.8%. At 24 months, 14.1% had persistent anxiety. Those with persistent anxiety had the highest mean HbA1c, particularly at 6 months (persistently anxious vs. persistently non-anxious: 9.9%±1.2% vs. 8.2%±1.9%, P=0.009). At baseline, 9.2% of subjects had depression. This group also had poorer glycemia at baseline (HbA1c of depressed vs non-depressed: 9.6%±2.1% vs. 8.5%±1.6%, P=0.04), which persisted up to 24 months.
The majority of YAD in Singapore have suboptimal glycemia. Psychological distress is a critical harbinger of poorer metabolic outcomes.
亚洲年轻糖尿病患者（YAD）的心理负担和代谢结果的纵向信息较少。我们旨在评估新加坡 YAD 队列中从过渡到基线及 2 年后心理状态与血糖之间的关系。
从新加坡总医院 YAD 诊所招募年龄在 17 至 25 岁的 1 型糖尿病（T1DM）和 2 型糖尿病（T2DM）患者。在过渡（基线）和 18 至 24 个月时进行医院焦虑和抑郁量表和糖尿病问题领域量表评估。在常规就诊期间评估糖化血红蛋白（HbA1c）并进行纵向跟踪。
2011 年 1 月至 2017 年 11 月期间共招募了 98 例 T1DM（74.8%）和 33 例 T2DM（25.2%）患者。基线时，平均 HbA1c 为 8.6%±1.7%。仅有 26.0%的患者 HbA1c 达到≤7.5%，16.8%的患者 HbA1c 达到<7%。基线时，焦虑患病率为 29.8%。24 个月时，14.1%的患者持续焦虑。持续焦虑的患者的平均 HbA1c 最高，特别是在 6 个月时（持续焦虑者 vs. 持续不焦虑者：9.9%±1.2% vs. 8.2%±1.9%，P=0.009）。基线时，9.2%的患者患有抑郁症。该组的血糖水平也较差（抑郁组与非抑郁组的 HbA1c：9.6%±2.1% vs. 8.5%±1.6%，P=0.04），这一情况一直持续到 24 个月。
新加坡的大多数 YAD 患者血糖控制不佳。心理困扰是代谢结果恶化的重要指标。
