创伤后应激障碍的严重程度,2型糖尿病的结果和全因死亡率:一个回顾性队列研究
Joanne Salas1, Wenjin Wang2, Paula P Schnurr3
1Department of Family and Community Medicine, Saint Louis University School of Medicine, 1402 South Grand Blvd, St. Louis, MO, United States; The Advanced HEAlth Data (AHEAD) Research Institute, Saint Louis University School of Medicine, 1402 South Grand Blvd, St. Louis, MO, United States.
Journal of psychosomatic research
|October 12, 2023
概括
患有创伤后应激障碍 (PTSD) 和2型糖尿病 (T2D) 的患者面临更高的微血管并发症风险. 然而,严重的PTSD可能会降低死亡风险,可能是由于医疗保健参与度增加. 建议在T2D患者中进行PTSD查.
科学领域:
- 医学研究 医学研究
- 临床流行病学临床流行病学
- 公共卫生 公共卫生
背景情况:
- 并发性创伤后应激障碍 (PTSD) 和2型糖尿病 (T2D) 可能导致糖尿病结果较差.
- 关于PTSD严重程度对T2D相关并发症和死亡率的影响的证据有限.
研究的目的:
- 调查PTSD严重程度与T2D结果之间的关联,包括胰岛素启动,高血糖,微血管并发症和全因死亡率.
- 评估特定的PTSD症状 (过度兴奋,负面情绪) 对T2D管理和结果的影响.
主要方法:
- 使用退伍军人卫生事务数据 (2012-2022财年) 的回顾性队列研究,对23161名患有PTSD和受控T2D的患者进行了研究.
- 使用DSM-5 (PCL-5) 评分 (轻度,中度,严重) 的PTSD检查清单对PTSD严重程度进行分类.
- 竞争风险和生存模型用于分析关联,控制混因素.
主要成果:
- 与轻度PTSD相比,中度和严重的PTSD与微血管并发症的风险增加显著相关.
- 过度兴奋症状与开始胰岛素治疗的风险降低了42%.
- 严重的PTSD与较低的全因死亡风险相关 (HR=0.76).
结论:
- 在患有T2D的患者中,并发性PTSD增加了微血管并发症的风险.
- 在这个群体中,较低的死亡风险可能归因于医疗保健利用率增加和早期发现疾病.
- 对T2D患者进行常规PTSD查是全面护理的建议.
相关概念视频
Diabetes Mellitus: Type 2 and Gestational
2.5K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.5K
Psychoneuroimmunology: Diabetes and Cancer
35
Chronic stress has been linked to both the onset and progression of serious health conditions, including Type 2 diabetes and cancer. Type 2 diabetes, a widespread chronic illness, is closely associated with obesity and insulin resistance, both of which often worsen under stress. Studies indicate that men experiencing high levels of chronic stress face a 45% higher risk of developing diabetes compared to those with minimal stress. Stress triggers physiological responses that elevate blood...
35
Diabetes: Symptoms, Diagnosis, and Complications
557
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
557
Diabetes Mellitus: Overview and Type I Subtype
2.7K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
2.7K
Pathophysiology of Diabetes
956
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
956
Carbohydrate Metabolism
11.2K
Carbohydrates are polymers composed of molecules containing atoms of carbon, hydrogen and oxygen. One gram of carbohydrate can provide four kilo-calories of energy, which makes it the most efficient instant energy source.
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
Starch accounts for approximately 60% of the carbohydrates consumed by humans. Since amylase enzymes cannot function in the stomach's acidic environment, starch can only be digested in the mouth and small intestine. Simple sugars are found naturally in milk and fruits in...
11.2K


