Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081, Ulm, Germany.
Institute of Epidemiology and Medical Biometry, ZIBMT, Ulm University, Albert-Einstein-Allee 41, Ulm, Germany.
Sci Rep. 2023 Jan 27;13(1):1556. doi: 10.1038/s41598-023-28373-x.
Mental comorbidities in patients with type 1 diabetes mellitus (T1D) are common, and can have a negative impact on acute blood glucose levels and long-term metabolic control. Information on the association of T1D and comorbid posttraumatic stress disorder (PTSD) with diabetes-related outcomes is limited. The aim was to examine the associations between a clinical diagnosis of PTSD and diabetes-related outcomes in patients with T1D. Patients with T1D and comorbid documented PTSD from the DPV database (n = 179) were compared to a group with T1D without PTSD (n = 895), and compared to a group with T1D without comorbid mental disorder (n = 895) by matching demographics (age, gender, duration of diabetes, therapy and migration background) 1:5. Clinical diabetes-related outcomes {body mass index (BMI), hemoglobin A1c (hbA1c), daily insulin dose, diabetic ketoacidosis (DKA), hypoglycemia, number of hospital admissions, number of hospital days} were analyzed, stratified by age groups (≤ 25 years vs. > 25 years). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD or patients without mental disorders had significantly higher HbA1c (8.71 vs. 8.30 or 8.24%), higher number of hospital admissions (0.94 vs. 0.44 or 0.32 per year) and higher rates of DKA (0.10 vs. 0.02 or 0.01 events/year). Patients with comorbid PTSD aged ≤ 25 years compared with patients without PTSD had significantly higher BMI (0.85 vs. 0.59) and longer hospital stays (15.89 vs.11.58 days) than patients without PTSD. Patients with PTSD > 25 years compared with patients without PTSD or without any mental comorbidities had significantly fewer hospital admissions (0.49 vs. 0.77 or 0.69), but a longer hospital length of stay (20.35 vs. 11.58 or 1.09 days). We found that PTSD in younger patients with T1D is significantly related to diabetes outcome. In adult patients with T1D, comorbid PTSD is associated with fewer, but longer hospitalizations. Awareness of PTSD in the care of patients with T1D should be raised and psychological intervention should be provided when necessary.
1 型糖尿病（T1D）患者常伴有精神共病，这可能对急性血糖水平和长期代谢控制产生负面影响。目前有关 T1D 与共患创伤后应激障碍（PTSD）与糖尿病相关结局之间关联的信息有限。本研究旨在探讨 T1D 患者 PTSD 临床诊断与糖尿病相关结局之间的关系。DPV 数据库中患有 T1D 合并有确诊 PTSD（n=179）的患者与 T1D 无 PTSD 组（n=895）和 T1D 无合并精神障碍组（n=895）进行比较，通过匹配年龄、性别、糖尿病病程、治疗和移民背景等人口统计学特征（1:5）进行比较。分析了临床糖尿病相关结局（体重指数（BMI）、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、住院次数、住院天数），并按年龄组（≤25 岁 vs. >25 岁）进行分层。与无 PTSD 或无精神障碍的患者相比，≤25 岁的合并 PTSD 的患者 HbA1c 更高（8.71 vs. 8.30 或 8.24%）、住院次数更多（0.94 vs. 0.44 或 0.32 次/年）、DKA 发生率更高（0.10 vs. 0.02 或 0.01 次/年）。与无 PTSD 的患者相比，≤25 岁的合并 PTSD 的患者 BMI 更高（0.85 vs. 0.59）、住院时间更长（15.89 vs. 11.58 天）。与无 PTSD 或无任何精神共病的患者相比，年龄较大的 PTSD 患者（>25 岁）住院次数明显减少（0.49 vs. 0.77 或 0.69），但住院时间更长（20.35 vs. 11.58 或 1.09 天）。我们发现，T1D 年轻患者的 PTSD 与糖尿病结局显著相关。在成年 T1D 患者中，共患 PTSD 与住院次数较少但住院时间较长有关。在 T1D 患者的护理中应提高对 PTSD 的认识，并在必要时提供心理干预。
