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糖尿病诊断对健康和幸福感的影响:来自英国老龄化纵向研究的发现。

The impact of a diabetes diagnosis on health and well-being: Findings from the English Longitudinal Study of Ageing.

机构信息

Health Psychology Section, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.

Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, UK.

出版信息

J Diabetes. 2024 Jul;16(7):e13518. doi: 10.1111/1753-0407.13518. Epub 2023 Dec 19.

Abstract

BACKGROUND

Poorer health and well-being are associated with diabetes risk. However, little is known about the trajectory of health and well-being from before to after diabetes diagnosis. We compared depressive symptoms, quality of life, self-rated health, and loneliness at three time points (prediagnosis, diagnosis, 2-4 years post diagnosis) in individuals who developed diabetes and a comparison group.

METHODS

Health and well-being measures were self-reported by 3474 participants from the English Longitudinal Study of Ageing. Repeated measures analysis of variance and generalized estimating equations were used to investigate differences by group, time, and group-by-time interactions.

RESULTS

A total of 473 (13.6%) participants developed diabetes. The diabetes group reported greater depressive symptoms (W(1) = 20.67, p < .001) and lower quality of life (F = 1, 2535 = 10.30, p = .001) and were more likely to rate their health as fair/poor (W(1) = 67.11, p < .001) across time points, adjusting for age, sex, and wealth. They also reported greater loneliness (F = 1, 2693 = 9.70, p = .002) in unadjusted analyses. However, this was attenuated to the null in adjusted analyses. The group-by-time interaction was significant for quality of life (F = 1.97, 5003.58 = 5.60, p = .004) and self-rated health (W(2) = 11.69, p = .003), with a greater decline in these measures over time in the diabetes group in adjusted analyses.

CONCLUSION

People who received a diabetes diagnosis had greater depressive symptoms, lower quality of life, and poorer self-rated health than those who did not develop diabetes. Quality of life and self-rated health deteriorated more rapidly following a diagnosis. Screening for these factors around the time of diagnosis could allow for interventions to improve the health and well-being of those with diabetes.

摘要

背景

较差的健康和幸福感与糖尿病风险相关。然而,人们对于糖尿病诊断前后健康和幸福感的轨迹知之甚少。我们比较了患有糖尿病的个体和对照组在三个时间点(诊断前、诊断时和诊断后 2-4 年)的抑郁症状、生活质量、自我报告健康状况和孤独感。

方法

3474 名参与者来自英国老龄化纵向研究,通过自我报告健康和幸福感的措施。使用重复测量方差分析和广义估计方程来研究组间、时间和组间时间交互作用的差异。

结果

共有 473 名(13.6%)参与者患有糖尿病。糖尿病组报告了更多的抑郁症状(W(1) = 20.67,p <.001)和更低的生活质量(F = 1,2535 = 10.30,p =.001),并且更有可能在整个时间点上自我报告健康状况为一般/较差(W(1) = 67.11,p <.001),调整了年龄、性别和财富因素。他们在未经调整的分析中还报告了更大的孤独感(F = 1,2693 = 9.70,p =.002)。然而,在调整后的分析中,这种情况减弱到了零。生活质量(F = 1.97,5003.58 = 5.60,p =.004)和自我报告健康状况(W(2) = 11.69,p =.003)的组间时间交互作用具有统计学意义,在调整后的分析中,糖尿病组的这些指标随着时间的推移呈现出更大的下降趋势。

结论

与未患糖尿病的人相比,被诊断患有糖尿病的人有更多的抑郁症状、更低的生活质量和更差的自我报告健康状况。生活质量和自我报告健康状况在诊断后恶化得更快。在诊断时对这些因素进行筛查,可以为改善糖尿病患者的健康和幸福感提供干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/134a/11212344/bda3dd24b595/JDB-16-e13518-g003.jpg

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