伊朗糖尿病相关困扰及其与糖尿病并发症的关联。
Diabetes-related distress and its association with the complications of diabetes in Iran.
作者信息
Khashayar Pouria, Shirzad Nooshin, Zarbini Aghil, Esteghamati Alireza, Hemmatabadi Mahboobeh, Sharafi Elham
机构信息
Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
Department of Endocrinology, Vali-Asr Hospital, Endocrinology and Metabolism Research Center (EMRC), Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, P. O. Box, Tehran, 13145-784 Iran.
出版信息
J Diabetes Metab Disord. 2022 Jul 27;21(2):1569-1575. doi: 10.1007/s40200-022-01103-2. eCollection 2022 Dec.
PURPOSE
Diabetes-related distress (DRD) has negative emotional effects on the patients' quality of life. This is while the condition often goes undiagnosed despite it being common among diabetic patients. This study investigated the prevalence of DRD and its association with diabetes complications among a group of Iranian type 2 diabetic patients (TDM).
METHODS
This descriptive-analytical cross-sectional study was conducted on 186 TDM patients referred to a diabetes clinic in a teaching hospital from the beginning of May 2019 to the end of April 2020. Two questionnaires on disease-related information and diabetes distress screening scale (DDS) were filled out for each patient. The latter was divided into four domains, emotional burden (EB), diabetes-related interpersonal distress (ID), physician-related distress (PD), and regimen-related distress (RD). In addition to the frequency of DRD and its association with age, sex, body mass index (BMI), hypertension, hemoglobin AC, duration of disease, and type of medication regimen (oral, insulin, or mix) along with the history of cardiovascular disease (CVDs), retinopathy, nephropathy, and diabetic foot were assessed.
RESULTS
DRD was reported in 47% of the patients. Being female, old age, hypertension, high hemoglobin AC levels, nephropathy, and retinopathy were significantly associated with DRD (P-value = < 0.001, 0.013, 0.014, 0.007, 0.001, and 0.004, respectively). The history of the diabetic foot had a significant relationship with PD and ID (P-value = 0.007 and < 0.001, respectively). Multivariate regression showed gender and the existence of complications to have a direct effect on the development of DRD.
CONCLUSION
DRD prevalence is relatively high and requires screening to identify and treat high-risk patients. Further studies are needed to study diabetes, its complications and their relation with DRD to help reduce such conditions and improve the patient's quality of life.
目的
糖尿病相关困扰（DRD）对患者的生活质量有负面情绪影响。尽管这种情况在糖尿病患者中很常见，但往往未被诊断出来。本研究调查了一组伊朗2型糖尿病患者（TDM）中DRD的患病率及其与糖尿病并发症的关联。
方法
本描述性分析横断面研究于2019年5月初至2020年4月底对转诊至一家教学医院糖尿病诊所的186例TDM患者进行。为每位患者填写了两份关于疾病相关信息的问卷和糖尿病困扰筛查量表（DDS）。后者分为四个领域，即情感负担（EB）、糖尿病相关人际困扰（ID）、医生相关困扰（PD）和治疗方案相关困扰（RD）。除了DRD的患病率及其与年龄、性别、体重指数（BMI）、高血压、糖化血红蛋白、病程、药物治疗方案类型（口服、胰岛素或混合）以及心血管疾病（CVD）史、视网膜病变、肾病和糖尿病足的关联外，还进行了评估。
结果
47%的患者报告有DRD。女性、老年、高血压、高糖化血红蛋白水平、肾病和视网膜病变与DRD显著相关（P值分别为<0.001、0.013、0.014、0.007、0.001和0.004）。糖尿病足病史与PD和ID有显著关系（P值分别为0.007和<0.001）。多因素回归显示性别和并发症的存在对DRD的发生有直接影响。
结论
DRD患病率相对较高，需要进行筛查以识别和治疗高危患者。需要进一步研究糖尿病及其并发症以及它们与DRD的关系，以帮助减轻此类情况并改善患者的生活质量。
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