Tilov Boris G, Stanchev Pavel, Orbetsova Maria, Becheva Elena, Antonov Petar, Ivanov Atanas S
Department of Psychology, Medical University of Plovdiv, Plovdiv, BGR.
Department of Endocrinology, Medical University of Plovdiv, Plovdiv, BGR.
Cureus. 2024 Oct 3;16(10):e70782. doi: 10.7759/cureus.70782. eCollection 2024 Oct.
There is a lack of multidisciplinary studies examining the link between psychological factors and glycemic control in individuals with chronic illnesses. The aim of this study is to investigate the relationship between psychological factors such as resilience, perceived stress, emotional regulation, aggressiveness, and glycated hemoglobin (HbA1c) levels in patients with type 2 diabetes. Additionally, the study seeks to determine the predictive value of perceived stress and resilience on HbA1c levels and to explore the role of anger expression and emotion regulation strategies in glycemic control, comparing diabetic patients to healthy controls.
The study was conducted between November 2021 and November 2023 at the Clinic of Endocrinology and Metabolic Diseases at the St. George University Hospital, Bulgaria, and the Department of Science and Research at the Medical University of Plovdiv, Bulgaria. Of these 84 individuals were diagnosed with type 2 diabetes, divided into two groups of 42 individuals each, who had poor and fair glycated hemoglobin. The third group was a healthy control consisting of 42 individuals in the same age group who had no established chronic diseases.
When comparing the study groups on HbA1c and individual psychological characteristics, there were statistically significant differences in resilience, perceived stress, emotion regulation suppression, and anger expression. When comparing the mean values of mental resilience with glycated hemoglobin levels, we find that there are statistically significantly higher mean values between the poor HbA1c control and the healthy group. From the regression analysis, we conclude that the psychological characteristics positively associated with perceived stress (β=0.502; p<0.001) and inversely associated with mental resilience (β=-0.359; p<0.001) are the most predictive. Less influential was the straight correlation with emotion regulation-expressive inhibition (β=0.226; p<0.05), the positive correlation with anger (β=0.170; p<0.001), and general aggressiveness (β=0.151; p<0.05).
From the present study, we note that glycated hemoglobin level is strongly influenced by two psychological predictors, namely subjective perception of stressful situations and resilience level.
缺乏多学科研究来探讨慢性病患者心理因素与血糖控制之间的联系。本研究的目的是调查2型糖尿病患者的心理因素，如心理韧性、感知压力、情绪调节、攻击性与糖化血红蛋白（HbA1c）水平之间的关系。此外，该研究旨在确定感知压力和心理韧性对HbA1c水平的预测价值，并探讨愤怒表达和情绪调节策略在血糖控制中的作用，将糖尿病患者与健康对照组进行比较。
该研究于2021年11月至2023年11月在保加利亚圣乔治大学医院内分泌与代谢疾病诊所以及保加利亚普罗夫迪夫医科大学科研部进行。这84名个体被诊断为2型糖尿病，分为两组，每组42人，糖化血红蛋白水平分别为较差和一般。第三组是健康对照组，由42名同年龄组且无慢性疾病的个体组成。
在比较各研究组的HbA1c和个体心理特征时，心理韧性、感知压力、情绪调节抑制和愤怒表达存在统计学显著差异。在比较心理韧性平均值与糖化血红蛋白水平时，我们发现HbA1c控制较差组与健康组之间的平均值在统计学上显著更高。通过回归分析，我们得出结论，与感知压力呈正相关（β=0.502；p<0.001）且与心理韧性呈负相关（β=-0.359；p<0.001）的心理特征最具预测性。与情绪调节表达抑制的直接相关性（β=0.226；p<0.05）、与愤怒的正相关性（β=0.170；p<0.001）以及一般攻击性（β=0.151；p<0.05）的影响较小。
从本研究中，我们注意到糖化血红蛋白水平受两个心理预测因素的强烈影响，即压力情境的主观感知和心理韧性水平。
