Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Centre for Diabetes Research (DZD), Neuherberg, Germany.
Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Ulm University, Ulm, Germany.
Psychiatry Res. 2021 Mar;297:113733. doi: 10.1016/j.psychres.2021.113733. Epub 2021 Jan 16.
The aim was to examine the relations between non-suicidal self-injury (NSSI) and clinical parameters as well as other psychiatric comorbidities in adolescents and young adults with type 1 diabetes mellitus (T1D). Patients aged 8-<=25 years with T1D and documented NSSI from the DPV database (n=167) were compared to a control group with T1D without NSSI or other psychiatric comorbidities (n=76,050) using multivariable regression models, adjusted for demographics. Clinical diabetes-related outcomes (haemoglobin A1c (HbA1c), daily insulin dose, diabetic ketoacidosis (DKA), hypoglycaemia, number of hospital days, number of hospital admissions) were analysed. NSSI patients had significantly higher HbA1c (%): (+1.1 [0.8; 1.4]), higher daily insulin doses: (+0.08 (U/kg), [0.02; 0.13]), more DKA events per patient year: (+1.79 [1.22; 2.37]), more hospital days per patient year: (+0.25 [0.20; 0.29]) and more frequent hospital admissions per patient year: (+0.93 [0.79; 1.06]) compared to T1D patients without NSSI or other psychiatric comorbidities (differences of adjusted estimates [confidence interval]). This is the first study to investigate the association between NSSI and T1D. We revealed that NSSI is significantly related to diabetes outcomes in adolescent T1D patients. There should be an increased awareness for NSSI in the care for adolescents and young adults with T1D.
目的是探讨 1 型糖尿病（T1D）青少年和年轻患者中，非自杀性自伤（NSSI）与临床参数以及其他精神共病之间的关系。将来自 DPV 数据库的 T1D 且有记录的 NSSI 患者（n=167）与 T1D 且无 NSSI 或其他精神共病的对照组（n=76050）进行比较，使用多变量回归模型，根据人口统计学进行调整。分析临床相关的糖尿病结局（糖化血红蛋白（HbA1c）、每日胰岛素剂量、糖尿病酮症酸中毒（DKA）、低血糖、住院天数、住院次数）。NSSI 患者的 HbA1c（%）显著升高（+1.1[0.8；1.4]），每日胰岛素剂量更高（+0.08（U/kg）[0.02；0.13]），每位患者年 DKA 事件更多（+1.79[1.22；2.37]），每位患者年住院天数更多（+0.25[0.20；0.29]），每位患者年住院次数更多（+0.93[0.79；1.06]），与 T1D 且无 NSSI 或其他精神共病的患者相比（调整估计值的差异[置信区间]）。这是第一项研究 NSSI 与 T1D 之间关联的研究。我们发现 NSSI 与青少年 T1D 患者的糖尿病结局显著相关。在 T1D 青少年和年轻患者的护理中，应该提高对 NSSI 的认识。
