在1型糖尿病青少年中,糖尿病困扰,抑郁和未来的血糖控制
Cecilia P Damilano1, K Ming Chan Hong1, Bethany A Glick2
1Division of Endocrinology, Nationwide Children's Hospital, The Ohio State University, Columbus, OH, USA.
抑郁症,通过较高的患者健康问卷 (PHQ-9) 评分来表明,公共保险预测1型糖尿病 (T1D) 青少年的血糖控制会恶化. 糖尿病困扰并不能预测未来的血糖控制.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 青少年健康 青少年健康
- 慢性疾病中的心理健康
背景情况:
- 患有1型糖尿病 (T1D) 的青少年经历了增加的糖尿病困扰和抑郁症,通常表现出较差的血糖控制.
- 这些心理因素与T1D青少年未来的血糖控制之间的预测关系仍然不清楚.
研究的目的:
- 调查糖尿病困扰和抑郁症得分是否预测T1D青少年未来的血糖控制 (HbA1c水平).
- 评估心理因素和保险状况对三年内血糖控制的纵向影响.
主要方法:
- 275名患有T1D的青少年 (13-17岁) 的队列完成了患者健康问卷 (PHQ-9) 和糖尿病青少年版本 (PAID-T) 的问题区域.
- 强大的排名顺序多变量回归分析被用于确定HbA1c在查后1,2,3年后的预测因素.
- 分析的变量包括年龄,糖尿病持续时间,基线HbA1c,PHQ-9得分,PAID-T得分和保险状况.
主要成果:
- 基线HbA1c是一年后HbA1c的显著预测指标.
- 查时更高的PHQ-9分数预测了2年和3年的HbA1c水平更高,并且也预测了随着时间的推移血糖控制的恶化.
- 还发现,公共保险状况预测未来血糖控制较差,并在三年内增加HbA1c.
- 糖尿病-青少年版本 (PAID-T) 的问题区域得分没有预测未来的血糖控制或HbA1c的变化.
结论:
- 抑郁症症状升高 (PHQ-9分数较高) 和公共保险状况是三年期间T1D青少年血糖控制恶化的重要预测因素.
- 通过PAID-T测量的糖尿病困扰似乎无法预测该人口未来的血糖控制.
- 这些发现强调了应对抑郁症的重要性,并考虑了在管理青少年T1D时的社会经济因素,如保险状况.
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