Swathi N L, P Venu Priyanka, M Devadarshini, Mohammed Adnaan Parvez, D Jothieswari, Umar Muhammad, Muhammad Ali Syed, Iqbal Javed, P Pravallika
Department of Pharmacy Practice, Jawaharlal Nehru Technological University Anantapur, Chittoor, IND.
Department of Chemistry, Sri Venkateswara College of Pharmacy, Chittoor, IND.
Cureus. 2025 Mar 20;17(3):e80890. doi: 10.7759/cureus.80890. eCollection 2025 Mar.
Background Diabetes distress (DD) is a significant barrier to effective diabetes management, impacting self-care behaviors and glycemic control. While most studies utilize glycated hemoglobin (HbA1c) as a standard marker for glycemic regulation, cost constraints often limit its availability. This study explores the shift from HbA1c to random blood sugar (RBS) as an alternative measure and assesses the impact of individualized interventions on DD and glycemic outcomes in individuals with uncontrolled type 2 diabetes mellitus (T2DM). Methods A quasi-experimental study was conducted on 180 participants aged 18-65 years, divided into an experimental group (n=82) receiving structured psychological and lifestyle counseling and a control group (n=98) receiving standard care. DD and RBS levels were recorded at baseline and after three months of the intervention. Statistical analyses included Pearson's correlation, student's t-test, and Wilcoxon signed-rank tests to evaluate changes in distress levels and glycemic control. Results Post-intervention, the experimental group showed a significant reduction in DD (t = 15.26, p < 0.001, Cohen's d = 1.685) and RBS (mean reduction = 10.68%), confirming the effectiveness of the structured interventions. The control group exhibited an unexpected increase in DD (t = -8.75, p < 0.001, Cohen's d = -0.960), whereas RBS remained largely unchanged (1.29% increase). A significant correlation (p = 0.000) between DD reduction and RBS improvement was observed. Conclusions Individualized interventions significantly reduced diabetes distress and improved glycemic outcomes, demonstrating that RBS may serve as a cost-effective alternative to HbA1c. Future research should focus on directly comparing RBS and HbA1c levels and evaluating the long-term sustainability of the intervention benefits across different age groups.
糖尿病困扰(DD)是有效管理糖尿病的重大障碍,会影响自我护理行为和血糖控制。虽然大多数研究将糖化血红蛋白(HbA1c)用作血糖调节的标准指标,但成本限制常常使其难以广泛应用。本研究探讨了用随机血糖(RBS)替代HbA1c作为指标的转变,并评估了个体化干预对2型糖尿病(T2DM)控制不佳患者的糖尿病困扰及血糖结果的影响。方法:对180名年龄在18至65岁之间的参与者进行了一项准实验研究,分为接受结构化心理和生活方式咨询的实验组(n = 82)和接受标准护理的对照组(n = 98)。在基线和干预三个月后记录糖尿病困扰和随机血糖水平。统计分析包括Pearson相关性分析、学生t检验和Wilcoxon符号秩检验,以评估困扰水平和血糖控制的变化。结果:干预后,实验组的糖尿病困扰显著降低(t = 15.26,p < 0.001,Cohen's d = 1.685),随机血糖也显著降低(平均降低 = 10.68%),证实了结构化干预的有效性。对照组的糖尿病困扰意外增加(t = -8.75,p < 0.001,Cohen's d = -0.960),而随机血糖基本保持不变(增加1.29%)。观察到糖尿病困扰降低与随机血糖改善之间存在显著相关性(p = 0.000)。结论:个体化干预显著降低了糖尿病困扰并改善了血糖结果,表明随机血糖可作为糖化血红蛋白的一种经济有效的替代指标。未来的研究应侧重于直接比较随机血糖和糖化血红蛋白水平,并评估不同年龄组干预效益的长期可持续性。