Rochate J, do Vale
Endocrinology Department, Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
Endocrinology Diabetes and Metabolism Department, Unidade Local de Saúde de Santa Maria, Lisbon, Portugal.
Hippokratia. 2024 Jan-Mar;28(1):17-21.
Background: Patient-reported outcome measures (PROMs) assess how individuals perceive the disease and its impact on quality of life, representing an important complement to the metabolic evaluation in type 1 diabetes mellitus (T1DM). This study aimed to assess the PROMs and their association with metabolic control.
A cross-sectional study of adults with T1DM was conducted in the outpatient Endocrinology department between October 2022 and May 2023. Clinical, demographic, and continuous glucose monitoring (CGM) data were collected. Three PROMs were applied: the diabetes psychological adjustment scale (ATT18), the World Health Organization well-being index (WHO-5), and the patient health questionnaire (PHQ-9). Descriptive and bivariate statistical analyses were performed.
We included 56 participants, aged 41.2 ± 14.6 years, 58 % female, and 64 % of medium-high socioeconomic class. The disease duration of the cohort was 21 ± 14.6 years, with 44.6 % on continuous subcutaneous insulin infusion (CSII) and 39.3 % presenting microvascular complications. Glycated hemoglobin of the cohort was 8.0 ± 1.4 %, time in range (TIR) 52 ± 22 %, coefficient of variation (CV) 37 ± 8 %, and median time below range (TBR) 2 %. Individuals on CSII had higher TIR (p =0.03). CV was related to TBR (ρ =0.643, p <0.001). The majority had satisfactory psychological adjustment to diabetes (ATT18 ≥60), which correlated directly with WHO-5 (r =0.511, p <0.001) and inversely with depression symptoms (r =-0.676, p <0.001). No relationships were identified between metabolic control and PROMs (p =0.63).
Including PROMs alongside detailed metabolic evaluation allows for individualized decision-making and active patient participation in diabetes management. These results underscore the importance of preventing depression, promoting well-being, and enhancing diabetes psychological adjustment in these patients, aiming to improve their quality of life. HIPPOKRATIA 2024, 28 (1):17-21.
背景：患者报告结局量表（PROMs）评估个体如何感知疾病及其对生活质量的影响，是1型糖尿病（T1DM）代谢评估的重要补充。本研究旨在评估PROMs及其与代谢控制的关联。
于2022年10月至2023年5月在门诊内分泌科对成年T1DM患者进行了一项横断面研究。收集了临床、人口统计学和连续血糖监测（CGM）数据。应用了三种PROMs：糖尿病心理调适量表（ATT18）、世界卫生组织幸福指数（WHO-5）和患者健康问卷（PHQ-9）。进行了描述性和双变量统计分析。
我们纳入了56名参与者，年龄为41.2±14.6岁，58%为女性，64%属于中高社会经济阶层。该队列的疾病病程为21±14.6年，44.6%接受持续皮下胰岛素输注（CSII），39.3%出现微血管并发症。该队列的糖化血红蛋白为8.0±1.4%，血糖在目标范围内时间（TIR）为52±22%，变异系数（CV）为37±8%，血糖低于目标范围的中位时间（TBR）为2%。接受CSII治疗的个体TIR较高（p =0.03）。CV与TBR相关（ρ =0.643，p <0.001）。大多数人对糖尿病有满意的心理调适（ATT18≥60），这与WHO-5直接相关（r =0.511，p <0.001），与抑郁症状呈负相关（r =-0.676，p <0.001）。未发现代谢控制与PROMs之间存在关联（p =0.63）。
将PROMs与详细的代谢评估相结合，有助于进行个体化决策，并使患者积极参与糖尿病管理。这些结果强调了在这些患者中预防抑郁、促进幸福和增强糖尿病心理调适的重要性，旨在提高他们的生活质量。《希波克拉底》2024年第28卷第1期：17 - 21页 。
