Emotional maladjustment, physical malaise and diabetic control in young chinese patients with diabetes

Abstract

We assessed a total of 93 diabetic patients attending the diabetic clinic at Queen M a y Hospital in late 1991 and followed them up in early 1994. The subjects studied were agedfiom 14 to 45 years, comprising 39 males and 54 females. Measures of psychological adjustment together with subjective complaints of somatic malaise were administered. Subjects' diabetic control was assessed through their HbA 1 c levels and presence of any diabetic-related complications. Our findings indicate that in the Hong Kong Chinese population, high risk factors leading to poor diabetic control should be identified through emotional maladjustments as well as physical complaintshalaise. Measures of compliance, psychological maladjustment (e.g. low selfesteem, pervasive depressive symptoms, increased physical complaints), and glucose control are highly correlated with each other. Baseline glucose control, early signs of psychological maladjustment and demographic moderator variables are predictive of metabolic control over time. The need for early identijication of the vicious feedback cycle is highlighted.

Predictors of Depression Symptoms in Patients with Diabetes in Slovakia

“…An extensive systematic review found an aggregated estimate of 11% of major depression and 31% of elevated depression symptoms among all patients with diabetes studied [2]. Three studies found prevalence of depression similar to our findings, specifically 3.8% [18], 6.1% [19], and 5.4% [20], respectively. Our study did not include a control group (patients without diagnosed diabetes).…”

“…Patients were classified according to the obtained PHQ9 score into four groups: "none or minimal depression (NM)" (PHQ9 scores of 0-4), "mild depression (Mi)" (PHQ9 scores of 5-9), "moderate depression (Mo)" (PHQ9 scores of [10][11][12][13][14], and "moderately severe or severe depression (MSS)" (PHQ9 scores of [15][16][17][18][19][20][21][22][23][24][25][26][27]. In the univariate analyses a set of demographic, social, and economic indicators and disease related indicators were created and differences were tested between the four depression groups.…”

Depression and Glycemic Control in a Sample of Patients with Type 2 Diabetes

“…The unadjusted observed relationship between depressive symptoms and glycemic control is linear throughout the complete range of observed BDI scores. This come in concordance with numerous cross sectional studies, [14][15][16][17] as well as a meta-analysis of 30 studies found depression is associated with suboptimal glycemic control with moderate effect size. 18 Although there many demographic, and clinical variables could influence glycemic control, the adjustment of this observed relationship for various demographic and clinical variables had weakened the relation but not eliminate it, after full adjustment only the major depressive disorder (MDD), and BDI scores higher than 25, but not the full range, were significant predictors for higher HbA1c (p= 0.034, and 0.046 respectively), which come in concordance with IDEA Tel study on elderly patients which found a significant correlation between depression and HbA1c at base line and a trend for depression to predict HbA1c when other factors were controlled.…”

Individuals with type 2 diabetes and depressive symptoms exhibited lower adherence with self-care

“…It is unclear from the existing literature whether depression in diabetes is associated with poor metabolic control. Several studies have shown that depression aggravates poor metabolic control [31][32][33][34], but others have reported no such association [22,[35][36][37][38]. A recent meta-analytic review of 30 previous reports indicated that depression is significantly (Z ϭ 5.3, P Ͻ .0001) associated with poor glycemic control [21]; the standardized effect size was small to moderate (effect size ϭ 0.17, 95% CI ϭ 0.13-0.21).…”