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Persistent Anxiety Is Associated with Higher Glycemia Post-Transition to Adult Services in Asian Young Adults with Diabetes

Diabetes & Metabolism Journal 2021년 45권 1호 p.67 ~ 76
Zhu Ling, Chandran Suresh Rama, Goh Su-Yen, Tan Wee Boon, Xin Xiaohui, Goh Su-Yen, Gardner Daphne Su-Lyn,
소속 상세정보
 ( Zhu Ling ) - Singapore General Hospital Department of Endocrinology
 ( Chandran Suresh Rama ) - Singapore General Hospital Department of Endocrinology
 ( Goh Su-Yen ) - Singapore General Hospital Department of Endocrinology
 ( Tan Wee Boon ) - Singapore General Hospital Division of Medicine
 ( Xin Xiaohui ) - Singapore General Hospital Division of Medicine
 ( Goh Su-Yen ) - Singapore General Hospital Department of Endocrinology
 ( Gardner Daphne Su-Lyn ) - Singapore General Hospital Department of Endocrinology

Abstract


Background: There is little longitudinal information on psychological burden and metabolic outcomes in young adults with diabetes (YAD) in Asia. We aimed to evaluate the association between psychological status and glycemia at baseline and 2 years following transition in a cohort of YAD in Singapore.

Methods: Subjects with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), aged 17 to 25 years, were recruited from the YAD clinic in Singapore General Hospital. The Hospital Anxiety and Depression and Problem Areas for Diabetes scales were administered at transition (baseline) and at 18 to 24 months. Glycosylated hemoglobin (HbA1c) assessed during routine visits was tracked longitudinally.

Results: A total of 98 T1DM (74.8%) and 33 T2DM (25.2%) subjects were recruited between January 2011 and November 2017. At baseline, mean HbA1c was 8.6%±1.7%. Only 26.0% achieved HbA1c of ≤7.5% and 16.8% achieved HbA1c of <7%. At baseline, prevalence of anxiety was 29.8%. At 24 months, 14.1% had persistent anxiety. Those with persistent anxiety had the highest mean HbA1c, particularly at 6 months (persistently anxious vs. persistently non-anxious: 9.9%±1.2% vs. 8.2%±1.9%, P=0.009). At baseline, 9.2% of subjects had depression. This group also had poorer glycemia at baseline (HbA1c of depressed vs non-depressed: 9.6%±2.1% vs. 8.5%±1.6%, P=0.04), which persisted up to 24 months.

Conclusion: The majority of YAD in Singapore have suboptimal glycemia. Psychological distress is a critical harbinger of poorer metabolic outcomes.

키워드

Anxiety; Depression; Diabetes mellitus, type 1; Diabetes mellitus, type 2; Young adult

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