Endocrinology and Nutrition Department, Hospital Clínico Universitario Valladolid, Avenida Ramón y Cajal 3, Valladolid, CP: 47005, Spain.
Centro de Investigación en Endocrinología y Nutrición Clínica (CIENC), Universidad de Valladolid, Avenida Ramón y Cajal 3, Valladolid, CP: 47005, Spain.
Endocrine. 2024 Oct;86(1):186-193. doi: 10.1007/s12020-024-03846-9. Epub 2024 May 24.
To evaluate the relationship between the GRI -component of hypoglycemia (CHypo) and hyperglycemia (CHyper)- with diabetes quality of life (DQoL), diabetes-related stress (DDS), perception of hypoglycemia (Clarke Test), visual analogic scale (VAS) and diabetes-knowledge (DKQ2) in T1D.
Cross-sectional study in 92 patients with T1D under intensive insulin treatment (21.7% CSII) and flash glucose monitoring (isCGM). Clinical, metabolic and glycometric parameters and quality of life/satisfaction questionnaires were analyzed.
92 patients (54.3% male, BMI 25.4 ± 4.5 kg/m, HbA1c 7.5 ± 1.0%, TIR 53.9 ± 15.9%) with mean age 36.1 ± 12.6years and 17.8 ± 11.3 T1D duration. The mean GRI was 60.6 ± 22.2 with a CHypo and CHyper of 5.9 ± 4.8 and 27.3 ± 14.4, respectively. 19.1% presented a pathological Clarke's test. Patients with TIR > 70% and GRI < 40 showed better VAS (8.8 ± 1.3 vs 9.3 ± 0.9, p < 0.05) and DDS (46.4 ± 22.1 vs 36.7 ± 16.6, p < 0.05) scores, showing no differences between groups. CHyper > 15 and Chypo > 3.4 were related to worse levels of DQoL (91.1 ± 23.9 vs 76.6 ± 18.6 and 94.6 ± 24.8 vs 79.8 ± 20.1, p < 0.01), DDS(49.8 ± 22.4 vs 35.7 ± 16.5 and 49.8 ± 22.4 vs 35.7 ± 16.5, p < 0.01),and DKQ2 (24.4 ± 4.3 vs 26.8 ± 5.2 and 24.1 ± 4.8 vs 26.0 ± 4.6, p < 0.05), respectively. Worse metabolic control defined by GRI correlated with worse scores in VAS (r = -0.209, p < 0.05), DQoL (r = 0.205, p < 0.05), and DDS (r = 0.205, p < 0.05). No difference was observed in knowledge´s scale. CHyper correlated with worse scores in VAS (r = -0.231, p < 0.05), DQoL (r = 0.422, p < 0.01), and DDS (r = 0.341, p < 0.01) and lower degree of knowledge DKQ2 (r = -0.231, p < 0.05). When analyzing DQoL as a dependent variable in a multiple lineal regression, only age (β = 0.747; p < 0.001) and CHyper (β = 0.717; p < 0.001) maintained statistical significance.
Higher GRI was related to worse quality of life, diabetes-related stress and satisfaction with treatment, analogous to the TIR results.CHyper an Chypo were related to a greater decline in quality of life, diabetes-related stress, and lower satisfaction with treatment.However, in a multiple linear regression, only CHyper maintained statistical significance.
评估低血糖（CHypo）和高血糖（CHyper）与 T1D 患者的生活质量（DQoL）、糖尿病相关压力（DDS）、低血糖感知（Clarke 测试）、视觉模拟量表（VAS）和糖尿病知识（DKQ2）之间的关系。
在接受强化胰岛素治疗（21.7%CSII）和闪光葡萄糖监测（isCGM）的 92 名 T1D 患者中进行横断面研究。分析临床、代谢和血糖参数以及生活质量/满意度问卷。
92 名患者（54.3%男性，BMI 25.4±4.5kg/m，HbA1c 7.5±1.0%，TIR 53.9±15.9%），平均年龄 36.1±12.6 岁，T1D 病程 17.8±11.3 年。平均 GRI 为 60.6±22.2，CHypo 和 CHyper 分别为 5.9±4.8 和 27.3±14.4。19.1%的患者出现病理性 Clarke 测试。TIR>70%和 GRI<40 的患者 VAS（8.8±1.3 vs 9.3±0.9，p<0.05）和 DDS（46.4±22.1 vs 36.7±16.6，p<0.05）评分更好，两组之间无差异。CHyper>15 和 Chypo>3.4 与 DQoL（91.1±23.9 vs 76.6±18.6 和 94.6±24.8 vs 79.8±20.1，p<0.01）、DDS（49.8±22.4 vs 35.7±16.5 和 49.8±22.4 vs 35.7±16.5，p<0.01）和 DKQ2（24.4±4.3 vs 26.8±5.2 和 24.1±4.8 vs 26.0±4.6，p<0.05）水平降低相关。血糖控制较差（GRI）与 VAS（r=-0.209，p<0.05）、DQoL（r=0.205，p<0.05）和 DDS（r=0.205，p<0.05）评分较差相关。知识量表无差异。CHyper 与 VAS（r=-0.231，p<0.05）、DQoL（r=0.422，p<0.01）和 DDS（r=0.341，p<0.01）评分降低和 DKQ2 知识程度降低（r=-0.231，p<0.05）相关。在多元线性回归中，当将 DQoL 作为因变量进行分析时，只有年龄（β=0.747；p<0.001）和 CHyper（β=0.717；p<0.001）保持统计学意义。
较高的 GRI 与生活质量、糖尿病相关压力和治疗满意度下降有关，与 TIR 结果相似。CHyper 和 Chypo 与生活质量、糖尿病相关压力和治疗满意度下降有关。然而，在多元线性回归中，只有 CHyper 保持统计学意义。
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