Coccaro Emil F, Drossos Tina, Kline David, Lazarus Sophie, Joseph Joshua J, de Groot Mary
Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Department of Psychiatry and Behavioral Neuroscience, Pritzker School of Medicine, The University of Chicago, IL, USA.
Prim Care Diabetes. 2022 Jun;16(3):381-386. doi: 10.1016/j.pcd.2022.03.002. Epub 2022 Mar 11.
One potential barrier for people with diabetes to reach glycemic goals is diabetes distress. Accumulating evidence suggests diabetes distress may be linked to individuals' emotion regulation capacities. Thus, we conducted two studies to elucidate a model for how emotion regulation impacts diabetes distress and A levels and determine preliminary effect size estimates for an intervention targeting poor emotion regulation on glycemic control.
Study I used structural equation modeling to assess the cross-sectional relationships between these variables in a sample of 216 individuals with Type 1 and Type 2 diabetes. Study II built on findings from Study I that highlighted the role of emotion regulation capacities in diabetes distress and A by conducting a pilot study of an emotion-focused behavioral intervention compared to treatment as usual in a sample of individuals with Type 2 diabetes.
Study I examined two potential explanatory models with one of the models (Model II) showing a more comprehensive view of the data revealing a total effect of poor emotional regulation of 42% of all effects on A levels. Study II tested an emotion-focused behavioral intervention in patients with Type 2 diabetes compared to treatment as usual and found medium sized reductions in A levels and smaller reductions in diabetes distress that correlated with changes in emotion regulation.
These studies suggest that, in people with diabetes, elevated A levels and diabetes distress are linked with poor emotion regulation. While the effect sizes from Study 2 are preliminary, an emotion-focused behavioral intervention may reduce both A and diabetes distress levels, through improvements in emotion regulation. Overall, these data suggest that targeting difficulties in emotion regulation may hold promise for maximizing improvement in diabetes distress and A in individuals with diabetes.
糖尿病患者实现血糖目标的一个潜在障碍是糖尿病困扰。越来越多的证据表明，糖尿病困扰可能与个体的情绪调节能力有关。因此，我们进行了两项研究，以阐明情绪调节如何影响糖尿病困扰和糖化血红蛋白（A1C）水平的模型，并确定针对情绪调节能力差的干预措施对血糖控制的初步效应量估计。
研究I使用结构方程模型评估了216名1型和2型糖尿病患者样本中这些变量之间的横断面关系。研究II基于研究I的结果，该结果强调了情绪调节能力在糖尿病困扰和糖化血红蛋白中的作用，在2型糖尿病患者样本中进行了一项以情绪为重点的行为干预的试点研究，并与常规治疗进行了比较。
研究I检验了两个潜在的解释模型，其中一个模型（模型II）对数据的显示更为全面，揭示了情绪调节不良对糖化血红蛋白水平的所有影响中，总效应为42%。研究II对2型糖尿病患者进行了一项以情绪为重点的行为干预，并与常规治疗进行了比较，发现糖化血红蛋白水平有中等程度的降低，糖尿病困扰的降低幅度较小，且与情绪调节的变化相关。
这些研究表明，在糖尿病患者中，糖化血红蛋白水平升高和糖尿病困扰与情绪调节能力差有关。虽然研究2的效应量是初步的，但以情绪为重点的行为干预可能通过改善情绪调节来降低糖化血红蛋白和糖尿病困扰水平。总体而言，这些数据表明，针对情绪调节困难可能有望使糖尿病患者的糖尿病困扰和糖化血红蛋白水平得到最大程度的改善。
