Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study.
Summary of "Are psychopathological features relevant predictors of glucose control in patients with type 2 diabetes? A prospective study."
Type 2 diabetes has been associated with an increased prevalence of psychopathology, in comparison with matched non-diabetic controls. However, the cross-sectional design of most studies does not allow causal inferences. The aim of the present study is the exploration of this possible association in patients with type 2 diabetes, in a longitudinal fashion. This prospective observational study was conducted on a consecutive series of 250 type 2 diabetic outpatients and a 1-year follow-up period was performed. At enrollment, a complete medical history was collected and hemoglobin A1c was measured. General psychopathology was assessed using the Symptom Checklist 90-revised and the Eating Disorder Examination Questionnaire. Among the 187 patients available at follow-up, factors associated with unsatisfactory glycemic control at follow-up were baseline hemoglobin A1c, insulin therapy, a longer duration of diabetes, higher scores on the Eating behavior, and Somatization scales. At multivariate analysis, the attainment of hemoglobin A1c ≤7 % was associated with baseline hemoglobin A1c (p = 0.01), insulin therapy (p = 0.016), and Eating behavior (p = 0.02), whereas duration of diabetes and Somatization were no longer significant after adjusting for confounders. The results of the present study suggest that clinical features have a much greater impact on attainment of therapeutic goals than psychopathology. However, there are several aspects, such as temperament, motivation, self-efficacy, and well-being, not assessed in the present study, which could be crucial. These areas should be adequately explored for obtaining an overall picture of the psychological determinants of appropriate metabolic control in diabetes.
Affiliation
Diabetes Agency, Careggi Teaching Hospital and University of Florence, Largo Brambilla 3, 50134, Florence, Italy, docrot@gmail.com.
Journal Details
This article was published in the following journal.
Name: Acta diabetologica
ISSN: 1432-5233
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22644473
- DOI: http://dx.doi.org/10.1007/s00592-012-0403-4
Medical and Biotech [MESH] Definitions
Glucose Clamp Technique
Maintenance of a constant blood glucose level by perfusion or infusion with glucose or insulin. It is used for the study of metabolic rates (e.g., in glucose, lipid, amino acid metabolism) at constant glucose concentration.
Acarbose
An inhibitor of alpha glucosidase that retards the digestion and absorption of carbohydrates in the small intestine and hence reduces the increase in blood-glucose concentrations after a carbohydrate load. It is given orally to non-insulin dependent diabetes mellitus patients where diet modification or oral hypoglycemic agents do not control their condition. (From Martindale The Extra Pharmacopoeia, 31st ed)
Diabetes Complications
Conditions or pathological processes associated with the disease of diabetes mellitus. Due to the impaired control of BLOOD GLUCOSE level in diabetic patients, pathological processes develop in numerous tissues and organs including the EYE, the KIDNEY, the BLOOD VESSELS, and the NERVE TISSUE.
Glucose Transporter Type 2
A glucose transport facilitator that is expressed primarily in PANCREATIC BETA CELLS; LIVER; and KIDNEYS. It may function as a GLUCOSE sensor to regulate INSULIN release and glucose HOMEOSTASIS.
Control Groups
Groups that serve as a standard for comparison in experimental studies. They are similar in relevant characteristics to the experimental group but do not receive the experimental intervention.
PubMed Articles
Psychopathological long-term outcome of schizophrenia - a review.
OBJECTIVE: In the past, the comparability of empirical studies that examined the course and outcome of schizophrenia was limited by their use of different diagnostic systems. Focussing on the psychopa...
Pulmonary arterial hypertension (PAH) is a devastating complication of systemic lupus erythematosus (SLE). We aim to estimate the putative predictors contributing to early identification of PAH, thus...
Psychological self-assessment scales in expert investigations.
BACKGROUND: Psychological self-assessment scales are frequently used in expert investigations of psychological disorders. At the same time the validity of these scales in this particular area of use h...
The majority of studies examining associations between clinical-diagnostic and empirical-quantitative approaches have concentrated only on the target diagnosis without taking into account any possible...
Independent predictors of cardiovascular risk in polycystic ovarian syndrome.
We aimed to determine the independent predictors of cardiovascular risk in polycystic ovarian syndrome (PCOS). Ninety-one PCOS and 51 control patients were enrolled to our prospective cross sectional...
Clinical Trials
Feasibility of Tight Blood Glucose Control With the Space TGC System in Surgical ICU Patients
Hyperglycemia is common in critically ill patients and associated with an adverse outcome. Thus, glycaemic control is an important issue in critical care. Despite extensive efforts of the...
Feasibility of Blood Glucose Control With the Space TGC System in Medical ICU Patients
Hyperglycemia is common in critically ill patients and associated with an adverse outcome. Thus, glycaemic control is an important issue in critical care. Despite extensive efforts of the...
Usability of Blood Glucose Control With the Space TGC System in Medical ICU Patients
Hyperglycemia is common in critically ill patients and associated with an adverse outcome. Thus, glycaemic control is an important issue in critical care. Despite extensive efforts of the...
Hyperglycaemia is commonly found in critically ill patients. Clinical studies demonstrated that tight blood glucose control in medical and surgical ICU patients results in a significant be...
Glucose Control In Hematopoetic Stem Cell Transplant
To determine whether intensive glucose control results in improved mortality and reduced hospital stay length by performing a randomized trial of intensive glucose management (blood glucos...
