High anxiety and depressive symptoms in partners of type 1 diabetes persons in a sample of the Brazilian population

Adaptation and psychometric assessment of the instrument "Partners of Adults with Type 1 Diabetes Distress Scale" in a Brazilian population

Objectives

To adapt the instrument "Partners of Adults with Type 1 Diabetes Distress Scale" (Partner-DDS) into Brazilian culture, and to evaluate the psychometric characteristics of the adapted version.

Methods

All the cultural adaptation steps of the measure's instruments were followed. The psychometric properties such as reliability (stability by test-retest; internal consistency), and convergent construct validity were performed.

Results

Of all 72 partners, 69.4% were male, mean age: 42.69 ± 14.09 years, mean of marriage duration: 14.74 ± 12.41 years, and mean schooling: 11.81 ± 3.91 years.The internal consistency of the instrument (Cronbach Alpha) was 0.90. The intra-class coefficient (stability) was 0.80 (0.72-0.84). The Spearman coefficient (convergent construct validity) between the Partner-DDS scale and the Anxiety subscale of the Hospital Anxiety and Depression Scale (HADS-A) was 0.4273 (p < 0.0002).

Conclusions

The steps of the instruments' cultural adaptation were appropriately performed. The Brazilian version of the Partner- DDS scale demonstrates reliable psychometric properties for being used in POPWT1D distress evaluation in Brazil.

Innovation

The cultural adaptation of Partner-DDS scale into Brazilian Portuguese is a helpful innovation to assess the emotional burden in POPWT1D. This tool could be used to provide education and psychological support for this population.

Perceived fear of COVID-19 infection according to sex, age and occupational risk using the Brazilian version of the Fear of COVID-19 Scale

We investigated the fear of COVID-19 infection after proper translation and cultural adaptation of the "Fear of COVID-19 Scale" to the Brazilian Portuguese language. A sample of 1,743 Brazilian participants were included. The scale showed excellent psychometric characteristics. Women showed higher anxiety levels. Fear of COVID-19 scores were lower in males with occupational risk of contamination. On the other hand, women and younger individuals showed higher fear of COVID-19 infection scores. The Brazilian Fear of COVID-19 Scale proved to be a reliable tool with excellent psychometric properties for identifying fear of COVID-19 infection in the Brazilian population.

How the COVID-19 outbreak affected patients with diabetes mellitus?

Background

Global COVID-19 outbreak has been such a stressful experience for most of the people. Using a web-based cross-sectional study, we aimed to evaluate the acute stress response, depression, and anxiety in patients with diabetes mellitus (DM) during the COVID-19 pandemic, and to examine the effect of these psychiatric problems on diet habits and glycemic controls of patients.

Methods

This web-based survey of COVID-19 was sent to the patients through the Whatsapp platform. All participants reported their demographic data, diabetes-related information, changes in self-monitoring blood glucose measurements, physical parameters, and eating habits after COVID-19, then completed Hospital Anxiety and Depression Scale (HADS) and the Impact of Event Scale, Revised (IES-R) questionnaires which assessed acute stress sypmtoms, anxiety, and depression.

Results

Three hundred and four patients with DM [(141 type 1 DM (T1D) and 163 type 2 (T2D)] were included in the study. In our study, female gender, higher BMI and weight, decreased in financial income after outbreak, presence of diabetic complications and comorbid diseases (i.e., retinopathy, neuropathy, diabetic foot, hypertension, dyslipidemia), worsened glycemic levels, increased carbohydrate consumption, and snacking were associated with higher anxiety and depression scores. Depression was higher in patients with T2D and duration of illness was correlated with acute stress level.

Conclusions

It is important to be aware of the possibility of acute stress, depression, and anxiety after pandemic in patients with DM whose glycemic control is impaired. Psychological problems should not be ignored beyond physical inactivity and worsening eating habits.

Berberine and Ginsenoside Rb1 Ameliorate Depression-Like Behavior in Diabetic Rats

Rhizoma coptidis (Huang-lian) and Asian ginseng have been widely used in the treatment of diabetes and other concurrent diseases with apparent effects. This study investigated the effects of the active ingredients of R. coptidis and ginseng, berberine and ginsenoside Rb1, on depression-like behavior in a rat diabetes model. The animal model was established via a high-fat diet and intraperitoneal injection of streptozotocin, while the animal's depression-like behavior was induced via chronic unpredictable mild stress. These experimental rats were divided into four groups: control, depression-like behavior (DLB), metformin plus fluoxetine hydrochloride (M+FH), and berberine plus ginsenoside Rb1 (B+GRb1) groups. Glucose metabolism and insulin resistance were evaluated by oral glucose test and glucose clamp study. Depression-like behavior was evaluated via behavioral analyses, including forced swim, sucrose preference, elevated plus maze, and open-field tests. HE and Nissl staining, plasma cortisol expression of adrenocorticotropic hormone, and brain-derived neurotrophic factor (BDNF) levels were assayed to explore the mechanisms of action. Compared with the control, rats in the DLB group had a significant increase in the levels of blood glucose and depression-like behavior. The B+GRb1 group significantly improved glucose metabolism and insulin resistance, reduced depression-like behavior, downregulated levels of plasma cortisol and adrenocorticotropic hormone under stress, and upregulated BDNF protein expression compared to the DLB rats. HE and Nissl staining data revealed that B+GRb1 protected neurons from pathological and morphological changes. Thus, berberine and ginsenoside Rb1 not only improved glucose metabolism in diabetic rats but also ameliorated their depression-like behavior under chronic unpredictable stress. Mechanistically, studied data with plasma hormonal levels and brain neuronal pathological/morphological changes supported the observed effects. The combination of berberine and ginsenoside Rb1 may have a clinical value in the management of diabetic patients with depression.