2型糖尿病患者胰岛素治疗前后血糖与情绪的相关性

Relationship between blood glucose and mood before and after insulin therapy in type 2 diabetic patients

目的观察2型糖尿病患者胰岛素治疗前、后血糖水平与情绪变化的相关性。方法选择某院首次接受胰岛素治疗的2型糖尿病患者161例,治疗前、后分别用汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评价患者的情绪,同时测量其空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平。根据治疗前患者的HAMD、HAMA评分将其分为抑郁研究组(研究1)和焦虑研究组(研究2),且≥7分者为观察组,<7分者为对照组。比较治疗前、后两组患者的血糖水平与情绪变化。结果治疗后,研究1、2组的HAMD(HAMA)评分、FPG、2 h PG、HbA1c均下降,差异均有统计学意义(P<0.05),且观察1组的HAMD评分、2 h PG均高于对照1组(P<0.05)。观察2组HAMA评分高于对照2组(P<0.05)。观察2组治疗前HbA1c水平高于对照2组,差异有统计学意义(P<0.05)。HAMD总评分与2 h PG具有显著相关性(ρ=0.182,P=0.021);HAMA总评分与FPG、2 h PG、HbA1c具有显著相关性(ρ=0.202,P=0.010)、(ρ=0.242,P=0.002)、(ρ=0.230,P=0.003)。结论 2型糖尿病患者胰岛素治疗前、后血糖水平与情绪变化具有相关性,糖尿病治疗护理中应该有效降糖且管理情绪,护理工作中更应该重视对糖尿病患者的个体化健康管理。

Objective To investigate the relationship between blood glucose and mood before and after insulin therapy in type 2 diabetic patients. Methods A total of 161 patients with type 2 diabetes who received insulin treatment for the first time in a hospital were recruited, and patient＇s mood were evaluated with the Hamilton Depression Scale （HAMD） and the Hamilton Anxiety Scale （HAMA） before and after the insulin treatment. The fasting plasma glucose （FPG）, 2-hour postprandial plasma glucose （2 h PG） and glycosylated hemoglobin （HbA1c） were also measured. Patients were divided into depression study group （study 1） and anxiety study group （study 2） according to the scores of the HAMD or HAMA before treatment, and patients with HAMD or HAMA≥7 were enrolled in the observation group, patients with HAMD or HAMA 〈7 were enrolled in the control group. The blood glucose and mood in the two groups before and after treatment were compared. Results After treatment, HAMD （HAMA） scores, FPG, 2 h PG, and HbA1c in the study group 1, 2 decreased （P〈0.05）. The HAMD score and 2 h PG level in the observation group 1 were significantly higher than those in the control group 1 （P〈0.05）. The HAMA score in the observation group 2 was higher than that in the control group 2 （P〈0.05）. Before treatment, the HbA1c level in the observation group 2 was significantly higher than that in the control group 2 （P〈0.05）.There was significant correlation between total score of HAMD and 2 h PG （ρ=0.182, P=0.021）. There were significant correlations between total score of HAMA and FPG, 2 h PG, and HbA1c （ρ=0.202, P=0.010）, （ρ=0.242, P=0.002）, （ρ=0.230,P=0.003）. Conclusion There is significant correlation between blood glucose and mood before and after insulin treatment in type 2 diabetic patients. Reducing blood sugar and managing emotions effectively are necessary in the treatment of diabetes. It should pay more attention to the individualized health management of diabetic patients in nursing work.