Department of Psychology, University of Mississippi, MS.
VA Center for Clinical Management Research, Ann Arbor, MI.
Ann Behav Med. 2021 Oct 4;55(10):949-955. doi: 10.1093/abm/kaaa081.
Patients with diabetes (PWD) often experience diabetes distress which is associated with worse self-management and glycemic control. In contrast, PWD who receive support from family and friends (supporters) have better diabetes outcomes.
To examine the associations of PWD diabetes distress and supporters' distress about PWDs' diabetes with supporters' roles and PWD cardiometabolic outcomes.
We used baseline data from 239 adults with Type 2 diabetes and their supporters participating in a longitudinal trial. PWD and supporter diabetes distress (high vs. low) were determined using the Problem Areas in Diabetes Scale-5. Outcomes included PWD-reported help from supporters with self-care activities, supporter-reported strain, PWD metabolic outcomes (glycemic control [HbA1c], systolic blood pressure [SBP], and non-HDL cholesterol) and 5 and 10 year risk of cardiac event (calculated using the United Kingdom Prospective Diabetes Study algorithm).
PWDs with high diabetes distress were more likely to report that their supporters helped with taking medications, coordinating medical care, and home glucose testing (p's < .05), but not more likely to report help with diet or exercise. High supporter distress was associated with greater supporter strain (p < .001). High supporter diabetes distress was associated with higher PWD HbA1c (p = .045), non-HDL cholesterol (p = .011), and 5 (p = .002) and 10 year (p = .001) cardiac risk.
Adults with high diabetes distress report more supporter help with medically focused self-management but not with diet and exercise. Supporter distress about PWD diabetes was consistently associated with worse outcomes. PWD diabetes distress had mixed associations with their diabetes outcomes.
糖尿病患者（PWD）经常经历糖尿病困扰，这与较差的自我管理和血糖控制有关。相比之下，得到家人和朋友（支持者）支持的 PWD 具有更好的糖尿病结果。
检查 PWD 糖尿病困扰和支持者对 PWD 糖尿病的困扰与支持者角色和 PWD 心脏代谢结果的关联。
我们使用了 239 名 2 型糖尿病患者及其支持者参与的纵向试验的基线数据。使用糖尿病问题区域量表-5 确定 PWD 和支持者的糖尿病困扰（高 vs. 低）。结果包括 PWD 报告的来自支持者的自我护理活动帮助、支持者报告的压力、PWD 代谢结果（血糖控制[HbA1c]、收缩压[SBP]和非高密度脂蛋白胆固醇）以及 5 年和 10 年的心脏事件风险（使用英国前瞻性糖尿病研究算法计算）。
糖尿病困扰较高的 PWD 更有可能报告他们的支持者帮助他们服药、协调医疗护理和家庭血糖测试（p<0.05），但不太可能报告帮助他们进行饮食或运动。高支持者困扰与更大的支持者压力相关（p<0.001）。高支持者糖尿病困扰与更高的 PWD HbA1c（p=0.045）、非高密度脂蛋白胆固醇（p=0.011）以及 5 年（p=0.002）和 10 年（p=0.001）的心脏风险相关。
高糖尿病困扰的成年人报告说，他们的支持者在医学重点的自我管理方面提供了更多帮助，但在饮食和运动方面没有提供帮助。支持者对 PWD 糖尿病的困扰与更差的结果始终相关。PWD 糖尿病困扰与他们的糖尿病结果有混合关联。
