Hong So-Hyeon, Jee Yongho, Sung Yeon-Ah, Hong Young Sun, Song Do Kyeong, Jung Hyein, Lee Hyejin
Division of Endocrinology and Metabolism, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, South Korea.
Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea.
J Diabetes Complications. 2025 Jan;39(1):108924. doi: 10.1016/j.jdiacomp.2024.108924. Epub 2024 Dec 1.
This study aimed to investigate the correlations between glycated hemoglobin (HbA1C) variability and diabetes distress (DD) and its subscales in older patients with type 2 diabetes mellitus.
The cross-sectional study analyzed 175 patients with type 2 diabetes mellitus, aged ≥60 years, and underwent HbA1C testing at least three times within a 2-year. HbA1C variability was assessed using the coefficient of variation (CV), standard deviation (SD), variability independent of the mean (VIM), and variability score. DD was assessed using a diabetes distress scale (DDS) questionnaire. We analyzed four DDS subscales, including emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). Significant DD was defined as a total score ≥ 34.
All four indices of HbA1C variability were positively correlated with DDS (r = 0.19, P = 0.01 in CV; r = 0.19, P = 0.01 in SD; r = 0.19, P = 0.02 in VIM; and r = 0.18, P = 0.02 in variability score). For the DD subscales, only EB showed a significant correlation with HbA1C variability (β = 0.72, SE = 0.35 in CV; β = 0.70, SE = 0.35 in SD; β = 0.66, SE = 0.31 in VIM; and β = 0.77, SE = 0.35 in variability score).
HbA1C variability was independently linked to DD, particularly the EB subscale in older type 2 diabetes patients. This underscores the need for DD screening and intervention in patients with high HbA1C variability, irrespective of their HbA1C levels or depressive symptoms.
本研究旨在探讨老年2型糖尿病患者糖化血红蛋白（HbA1C）变异性与糖尿病痛苦（DD）及其各分量表之间的相关性。
这项横断面研究分析了175例年龄≥60岁的2型糖尿病患者，这些患者在2年内至少接受了3次HbA1C检测。使用变异系数（CV）、标准差（SD）、均值独立变异（VIM）和变异得分评估HbA1C变异性。使用糖尿病痛苦量表（DDS）问卷评估DD。我们分析了四个DDS分量表，包括情绪负担（EB）、治疗方案困扰（RD）、人际困扰（ID）和医生困扰（PD）。显著的DD定义为总分≥34。
HbA1C变异性的所有四个指标均与DDS呈正相关（CV中r = 0.19，P = 0.01；SD中r = 0.19，P = 0.01；VIM中r = 0.19，P = 0.02；变异得分中r = 0.18，P = 0.02）。对于DD分量表，只有EB与HbA1C变异性显示出显著相关性（CV中β = 0.72，SE = 0.35；SD中β = 0.70，SE = 0.35；VIM中β = 0.66，SE = 0.31；变异得分中β = 0.77，SE = 0.35）。
HbA1C变异性与DD独立相关，尤其是老年2型糖尿病患者的EB分量表。这强调了对HbA1C变异性高的患者进行DD筛查和干预的必要性，无论其HbA1C水平或抑郁症状如何。
