社区2型糖尿病血糖控制及伴发抑郁障碍相关分析

Correlation analysis of blood glucose control and associated depression in type 2 diabetes mellitus patients in community

目的调查社区2型糖尿病(T2DM)患者血糖控制及其伴发的抑郁情绪障碍并进行相关因素分析。方法选择2016年5-9月在华润武钢总医院辐射社区的158例T2DM患者,收集患者的一般情况、代谢指标等,同时采用糖尿病自我护理行为量表(SDSCA)、社会支持评定量表(SSRS)和抑郁自评量表(SDS)对患者进行问卷调查。结果抑郁组和非抑郁组在年龄、年龄分组(≤60岁/>60岁)、劳动类型、病程、BMI、SBP、DBP、TC、LDL-C指标上的差异无统计学意义(P均>0.05)。在性别、并发症、婚姻情况、HbA1c和TG上差异有统计学意义(P<0.05)。T2DM患者自我护理行为中的血糖监测因子与社会支持的客观支持维度呈正相关(P<0.05);T2DM患者自我护理行为量表中的总体饮食因子与HbA1c水平呈负相关,吸烟因子与抑郁情绪障碍评分呈正相关(P<0.01); T2DM患者社会支持评定量表中的对支持利用度因子、社会支持总分因子与HbA1c水平呈负相关,主观支持维度因子、对支持利用度因子、社会支持总分因子与抑郁情绪障碍评分呈负相关(P<0.05); HbA1c、TG与抑郁情绪障碍评分呈正相关(P均<0.01)。社会支持在HbA1c水平和抑郁障碍评分的关系中有完全中介作用。结论 T2DM患者抑郁情绪障碍患病率较高。2型糖尿病患者的自我护理、社会支持可改善其血糖控制,同时缓解其伴发的抑郁情绪障碍。

Objective To investigate the glycemic control and the associated depression in patients with type 2 diabetes in the community and to analyze the related factors. Methods 158 patients with T2 DM were selected from the radiation community of the General Hospital of Wuhan Iron and Steel Co. from May to September 2016. d the general conditions and metabolic indicators of the patients were collected. At the same time, the patients were investigated by the Summary of Diabetes Self-Care Activities(SDSCA), Social Support Rating Scale(SSRS) and Self-rating Depression Scale(SDS). Results There was no significant difference in age, age group(< 60 years/>60 years), type of work, course of disease, BMI, SBP, DBP, TC, LDL-C between depression group and non-depression group(P>0.05). There were significant differences in gender, complications, marital status, HbA1 c and TG content(P<0.05). The blood sugar monitoring factors in self-care behavior of patients with T2 DM were positively correlated with the objective support dimension of social support(P<0.05);the total dietary factors in self-care behavior scale of patients with T2 DM were negatively correlated with HbA1 c level, and the smoking factors were positively correlated with depressive disorder score(P<0.01);the support utilization factors and total social support in social support scale of patients with T2 DM were positively correlated with HbA1 c level(P<0.01). The scores were negatively correlated with the level of HbA1 c, and the scores of subjective support dimension, support utilization and total social support were negatively correlated with depressive disorder(P<0.05), while HbA1 c and TG were positively correlated with depressive disorder(P<0.01). Social support plays a completely mediating role in the relationship between HbA1 c level and depression score. Conclusion The incidence of depression was higher in T2 DM patients. The self-care and social support of type 2 diabetes patients can improve their glycemic control and alleviate the depression mood disorder.