2型糖尿病患者心理痛苦现状及其对血糖控制的影响

Psychological distress and its effects on glycemic control in patients with type 2 diabetes

目的调查2型糖尿病患者心理痛苦现况以及其对血糖控制的影响，为促进其身心健康及疾病管理提供依据。方法采用方便抽样法抽取87例2型糖尿病患者为研究对象。使用中文版糖尿病心理痛苦量表（DDS）和糖化血红蛋白（HbA1c）测评研究对象的心理痛苦水平和血糖控制状况。比较血糖控制达标者（HbA1c〈7%）与未达标者（HbA1c≥7%）DDS得分以及一般资料，并分析心理痛苦水平和血糖控制的相关性。结果研究对象平均DDS总分为（2.29±1.10）分；HbA1c水平与DDS总分、情感负担、治疗相关痛苦以及人际间痛苦均呈正相关（r值分别为0.46，0.45，0.48，0.25；P〈0.05）。多元线性回归分析提示，年龄、性别、BMI、糖尿病病程以及DDS总分是HbA1c水平的影响因素。结论2型糖尿病患者的心理痛苦水平是影响血糖控制的一个重要因素。今后的临床实践中，应重视2型糖尿病患者心理痛苦的评估与干预；同时在科研中，应通过干预性研究验证对糖尿病患者心理痛苦进行干预是否会改善其血糖控制情况。

Objective To investigate the diabetes distress and its effects on glycemic control in patients with type 2 diabetes （ T2DM）, and provide guidance for the promotion of psychophysical wellbeing and disease management. Methods This is a correlational study that enrolled 87 patients with T2DM by using convenience sampling method. The diabetes distress and glycemic control were evaluated by using the diabetes distress scale （DDS） and glycosylated hemoglobin HbAlc. DDS score and general information was compared between participants who had a good glycemic control （HbA1c〈7%） and those who had a poor glycemic control （HbAlc ≥ 7% ）, and the relationship between diabetes distress and glycemic control was analysised. Results The mean total distress score was （2.29± 1.10）. HbAlc level was positively correlated with total DDS score, emotional distress, regimen-related distress, and inter-personal distress （ r = 0.46,0.45,0.48,0.25 ; P 〈 0.05 ）. Multiple linear regression analysis indicated that, if age, gender, BMI, and diabetes duration were controlled, DDS total score was a significant influencing factor of HbAlc level.Conclusions The level of psychological distress is an important factor for glycemic control in people with T2DM. This underscores the importance of assessment and intervention of diabetes distress in clinical practice. Meanwhile, experimental study should be designed to examine the effects of psychologicaldistress on glycemic control.