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Kang GA, Yoon JY. Is the change in longitudinal cognitive function in older adults with diabetes affected by trajectory classes of depressive symptoms? Public Health Nurs 2024; 41:1006-1015. [PMID: 39054273 DOI: 10.1111/phn.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 06/02/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE This study aims to identify classes based on the trajectory of depressive symptoms and to examine the impact of trajectory classes of depressive symptoms on longitudinal changes in cognitive function in older adults with diabetes. METHODS This is a secondary data analysis of 572 older adults with diabetes using data from the 5th (2014) to 8th (2020) wave of the Korean longitudinal study of aging. Analysis of latent class growth and the effect of trajectories of depressive symptoms on cognitive function was examined using a latent growth curve model. This analysis has been found to be functional in change trajectories and in describing the direction of the trajectory. RESULTS The trajectory of depressive symptoms was classified into four classes: low-stable (36.89%), high-decreasing (20.28%), low-increasing (18.71%), and high-persistent (24.13%). Compared with the high-persistent class, higher initial levels of cognitive function were observed in the high-decreasing and low-stable classes. Compared with the high-persistent class, a slower rate of cognitive decline was observed in the low-stable class (B = 0.410, p = .021). CONCLUSIONS Continuous monitoring of depressive symptoms and early management of depressive symptoms for community-dwelling older adults with diabetes can help prevent the cognitive decline and delay the deterioration of cognitive function.
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Affiliation(s)
- Gyeong A Kang
- College of Nursing, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, South Korea
| | - Ju Young Yoon
- College of Nursing, Seoul National University, Seoul, South Korea
- Center for Human-Caring Nurse Leaders for the Future by Brain Korea 21 (BK 21) four project, College of Nursing, Seoul National University, Seoul, South Korea
- Research Institute of Nursing Science, Seoul National University, Seoul, South Korea
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Barnard-Kelly K, Marrero D, de Wit M, Pouwer F, Khunti K, Hermans N, Pierce JS, Laffel L, Holt RIG, Battelino T, Naranjo D, Fosbury J, Fisher L, Polonsky W, Weissberg-Benchell J, Hood KK, Schnell O, Messer LH, Danne T, Nimri R, Skovlund SE, Mader JK, Sherr JL, Schatz D, O'Neill S, Doble E, Town M, Lange K, de Beaufort C, Gonder-Frederick L, Jaser SS, Liberman A, Klonoff D, ElSayed NA, Bannuru RR, Parkin CG, Snoek F. Towards the standardisation of adult person-reported outcome domains in diabetes research: A Consensus Statement development panel. Diabet Med 2024; 41:e15332. [PMID: 38751219 DOI: 10.1111/dme.15332] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 07/23/2024]
Abstract
Diabetes is unique among chronic diseases because clinical outcomes are intimately tied to how the person living with diabetes reacts to and implements treatment recommendations. It is further characterised by widespread social stigma, judgement and paternalism. This physical, social and psychological burden collectively influences self-management behaviours. It is widely recognised that the individual's perspective about the impact of trying to manage the disease and the burden that self-management confers must be addressed to achieve optimal health outcomes. Standardised, rigorous assessment of mental and behavioural health status, in interaction with physical health outcomes is crucial to aid understanding of person-reported outcomes (PROs). Whilst tempting to conceptualise PROs as an issue of perceived quality of life (QoL), in fact health-related QoL is multi-dimensional and covers indicators of physical or functional health status, psychological and social well-being. This complexity is illuminated by the large number of person reported outcome measures (PROMs) that have been developed across multiple psychosocial domains. Often measures are used inappropriately or because they have been used in the scientific literature rather than based on methodological or outcome assessment rigour. Given the broad nature of psychosocial functioning/mental health, it is important to broadly define PROs that are evaluated in the context of therapeutic interventions, real-life and observational studies. This report summarises the central themes and lessons derived in the assessment and use of PROMs amongst adults with diabetes. Effective assessment of PROMs routinely in clinical research is crucial to understanding the true impact of any intervention. Selecting appropriate measures, relevant to the specific factors of PROs important in the research study will provide valuable data alongside physical health data.
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Affiliation(s)
| | | | | | - Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense, Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Norbert Hermans
- Research Institute of the Diabetes Academy Mergentheim (FIDAM), Mergentheim, Germany
| | - Jessica S Pierce
- Center for Healthcare Delivery Science, Nemours Children's Hospital, Orlando, Florida, USA
| | - Lori Laffel
- Joslin Diabetes Center, Boston, Massachusetts, USA
| | | | - Tadej Battelino
- Faculty of Medicine, University Medical Center Ljubljana, University of Ljubljana, Ljubljana, Slovenia
| | - Diana Naranjo
- Stanford University School of Medicine, San Francisco, California, USA
| | | | - Lawrence Fisher
- University of California San Francisco, San Francisco, California, USA
| | | | - Jill Weissberg-Benchell
- Pritzker Department of Psychiatry and Behavioral Health, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA
| | - Korey K Hood
- Department of Pediatrics, Division of Endocrinology and Diabetes, Stanford University School of Medicine, Palo Alto, California, USA
| | | | - Laurel H Messer
- Barbara Davis Center, University of Colorado, Boulder, Colorado, USA
- Tandem Diabetes Care, San Diego, California, USA
| | - Thomas Danne
- Diabetes-Center for Children and Adolescents, Hannover, Germany
| | - Revital Nimri
- The Jesse Z and Sara Lea Shafer Institute for Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
- Israel and Sacker Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Julia K Mader
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Jennifer L Sherr
- Department of Pediatrics, Yale School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Desmond Schatz
- Diabetes Institute, University of Florida College of Medicine, Gainesville, Florida, USA
- American Diabetes Association, Gainesville, Florida, USA
| | | | | | - Marissa Town
- Children with Diabetes, Cincinnati Children's Hospital, Cincinnati, Ohio, USA
| | - Karin Lange
- Hannover Medical School, Department Medical Psychology, Hannover, Germany
| | - Carine de Beaufort
- Centre Hospitalier de Luxembourg, GD de Luxembourg, Technology and Medicine, University of Luxembourg, Luxembourg, Belgium
| | - Linda Gonder-Frederick
- Center for Diabetes Technology, Center for Behavioral Health and Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, USA
| | - Sarah S Jaser
- Vanderbilt University Medical Center, Department of Pediatrics, Nashville, Tennessee, USA
| | - Alon Liberman
- Jesse Z. and Sara Lea Shafer Institute of Endocrinology and Diabetes, National Center for Childhood Diabetes, Schneider Children's Medical Center of Israel, Petah Tikvah, Israel
| | - David Klonoff
- Mills-Peninsula Medical Center, San Mateo, California, USA
| | - Nuha A ElSayed
- Health Care Improvement, American Diabetes Association, Arlington, Virginia, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Raveendhara R Bannuru
- Medical Affairs and QI Outcomes, American Diabetes Association, Arlington, Virginia, USA
| | | | - Frank Snoek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Medical Psychology, Amsterdam, The Netherlands
- Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
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Brückner RM, Schönenberg A, Wientzek R, Schreiber M, Prell T. Exploring factors associated with self-rated health in individuals with diabetes and its impact on quality of life: Evidence from the Survey of Health, Ageing, and Retirement in Europe. J Diabetes 2024; 16:e13522. [PMID: 38168898 PMCID: PMC11333853 DOI: 10.1111/1753-0407.13522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 11/13/2023] [Accepted: 12/03/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-rated health (SRH), a measure of self-reported general health, is a robust predictor of morbidity and mortality in various populations, including people with diabetes. Diabetes is negatively associated with SRH and quality of life (QoL). Little is known about how people with diabetes rate their health and which aspects influence the rating. Also, the predictive value of SRH on future QoL has not yet been evaluated. METHODS We analyzed data from 46 592 participants of the Survey of Health, Ageing and Retirement in Europe (SHARE). Using linear regression, we aimed to determine which sociodemographic, socioeconomic, medical, social, mental, and health behavior factors determine SRH in people with diabetes. In addition, we analyzed the predictive value of SRH on future QoL using the generalized estimating equations procedure. RESULTS We determined that country, current job situation, hospitalization, pain, polypharmacy, memory, eyesight, activities of daily living, number of chronic diseases, and depression are all linked to SRH. Together these variables explained 38% of the SRH's variance, whereas depression, pain, and memory had the greatest influence on SRH of people with diabetes. We also found that SRH independently predicted future QoL, supported by a regression coefficient of β = -1.261 (Wald chi-square test, χ2 = 22.097, df = 1, p < .05). CONCLUSIONS As SRH is linked to future QoL, we conclude that incorporating SRH assessment into medical evaluations can help health care professionals gaining a more comprehensive understanding of an individual's health trajectory and supporting patients to enhance their QoL.
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Affiliation(s)
| | | | | | - Mandy Schreiber
- Department of Internal Medicine IIHalle University HospitalHalleGermany
| | - Tino Prell
- Department of GeriatricsHalle University HospitalHalleGermany
- Department of NeurologyJena University HospitalJenaGermany
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Shalaeva E, Bano A, Kasimov U, Atakov S, Mirakhmedova K, Dadabaeva N, Laimer M, Saner H. Depression and anxiety symptoms are underestimated risk factors for postoperative prognosis in patients with Type 2 diabetes and peripheral artery disease undergoing partial foot amputation: Results from a prospective cohort study. J Psychosom Res 2024; 183:111824. [PMID: 38865804 DOI: 10.1016/j.jpsychores.2024.111824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 06/03/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
OBJECTIVE The aim of this study was to evaluate the prevalence and impact of depression and anxiety symptoms on post-operative prognosis and 1-year all-cause mortality in a large unique cohort of patients with Type 2 diabetes (T2D) and peripheral artery disease (PAD) after partial foot amputation (PFA). METHODS Prospective cohort study with 1-year follow-up of 785 consecutive patients (mean age 60.9 ± 9.1 years; 64.1% males) with T2D and PAD after PFA. Depressive symptoms were assessed by Patient Health Questionnaire-9 (PHQ-9) and anxiety symptoms by Hamilton Anxiety Rating Scale (HARS). We used multivariable Cox proportional hazard models to examine the association of depression and anxiety with all-cause mortality. RESULTS One-year all-cause mortality was 16.9% (n = 133). 331 (42.1%) patients had PHQ-9 score ≥ 10 indicating major depressive disorder. After adjusting for confounders, PHQ-9 score ≥ 10 was associated with an increased risk of 1-year all-cause mortality (HR = 1.68 (95%CI[1.16-2.44], p = 0.006). Depression dimensions of negative self-feeling and suicidal ideations were independently associated with 1-year mortality (HR = 1.26 (95%CI[1.24-1.55], p = 0.029 and HR = 2.37 (95%CI[1.89-2.96], p < 0.001, respectively). Compared to no depression, severe depressive symptoms (cut-off≥20) were associated with increased all-cause mortality (HR = 3.9 (95%CI [1.48-10.29], p = 0.006). Compared to no anxiety, severe anxiety symptoms (cut-off>30) were associated with increased 1-year mortality (HR = 2.25(95%CI [1.26-4.05], p = 0.006). CONCLUSION Depressive symptoms and severe anxiety have shown independently increased risk of 1-year all-cause mortality in patients with T2D and PAD requiring PFA. Our results indicate that screening for anxiety and depression should be considered under these circumstances to identify patients at increased risk to allow appropriate intervention.
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Affiliation(s)
- Evgeniya Shalaeva
- Graduate School for Health Sciences, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland; School of Medicine, Central Asian University, 264, Milliy bog St, Mirzo Ulugbek dist, Tashkent 111221, Uzbekistan; Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan.
| | - Arjola Bano
- Institute for Social and Preventive Medicine, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland; Department of Cardiology, Inselspital, Bern University Hospital, University Hospital Bern: Inselspital, 3010 Bern, Switzerland.
| | - Ulugbek Kasimov
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | - Sarvar Atakov
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | | | - Nailya Dadabaeva
- Tashkent Medical Academy, 2, Farobiy Street, Таshkent 100109, Uzbekistan
| | - Markus Laimer
- Clinic for Diabetology, Endocrinology, Nutrition and Metabolism, University Hospital Bern: Inselspital, 3010 Bern, Switzerland.
| | - Hugo Saner
- Institute for Social and Preventive Medicine, University of Bern, Hochschulstrasse 4, 3012 Bern, Switzerland.
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Zeng N, Li C, Mei H, Wu S, Liu C, Wang X, Bao Y. Temporal Relationship between HbA1c and Depressive Symptom Trajectories in a Longitudinal Cohort Study: The Mediating Role of Healthy Lifestyles. Brain Sci 2024; 14:780. [PMID: 39199473 PMCID: PMC11353008 DOI: 10.3390/brainsci14080780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/24/2024] [Accepted: 07/27/2024] [Indexed: 09/01/2024] Open
Abstract
This study analyzed China Health and Retirement Longitudinal Study data to explore the HbA1c-depression link, including depressive trajectories, while considering the mitigating impact of healthy lifestyles. Cross-lagged panel models and group-based trajectory modeling were performed to investigate the temporal relationship between HbA1c levels and depressive symptoms, as well as the depressive trajectories. Structural equation models were used to assess the mediating effects of healthy lifestyles. The mean age of the participants was 57.66 ± 9.04 years, with 53.68% being female. Analyzing 8826 participants across three waves, we observed a significant prediction of subsequent depressive symptoms by the preceding HbA1c levels (β = 0.296; p < 0.001). Four distinct trajectories of depressive symptoms were distinguished: stable low, stable moderate, increasing, and stable high. Elevated HbA1c levels were associated with a higher risk of developing stable high (OR 1.12 and 95% CI 1.02-1.23), increasing (OR 1.21 and 95% CI 1.11-1.32), and stable moderate depressive symptoms (OR 1.07 and 95% CI 1.01-1.13). Engaging in two healthy life behaviors reduced stable high and increasing depressive pattern risks by 32% and 30%, respectively. Adherence to a healthy lifestyle lessened 7.2% of the impact of high HbA1c levels on the subsequent depressive symptoms. These findings highlight the potential benefits of incorporating adequate sleep and light physical activities, which might reduce the adverse impact of elevated HbA1c levels on depressive symptoms.
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Affiliation(s)
- Na Zeng
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Chao Li
- Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Huan Mei
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Shuilin Wu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Chang Liu
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Xiaokun Wang
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
| | - Yanping Bao
- School of Public Health, Peking University, Beijing 100191, China; (N.Z.); (H.M.); (S.W.); (C.L.); (X.W.)
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing 100191, China
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Mangoulia P, Milionis C, Vlachou E, Ilias I. The Interrelationship between Diabetes Mellitus and Emotional Well-Being: Current Concepts and Future Prospects. Healthcare (Basel) 2024; 12:1457. [PMID: 39057600 PMCID: PMC11276337 DOI: 10.3390/healthcare12141457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 07/19/2024] [Accepted: 07/19/2024] [Indexed: 07/28/2024] Open
Abstract
Diabetes mellitus is a lifelong metabolic disorder that impacts people's well-being and biopsychosocial status. Psychiatric problems and diabetes mellitus have a complex, reciprocal interaction in which one condition affects the other. In this narrative review, we provide an overview of the literature on the psychological effects of diabetes, expound on the evaluation of emotional disorders in the setting of diabetes, and suggest interventions aimed at enhancing both mental and physical health. Diabetes can make daily life complicated and stressful. Frequent blood glucose testing, taking medications on a regular basis, adhering to a tight diet plan, and exercising are some examples of the suggested daily routine of subjects with diabetes. Furthermore, comorbid diseases and typical diabetic complications can have a detrimental impact on quality of life. When mental health conditions coexist with diabetes mellitus, there is a greater likelihood of medication noncompliance, a decreased commitment to diabetes-related self-care, increased functional impairment, inadequate glycemic control, a higher risk of complications, and overall higher healthcare expenses. Thus, evaluation of the mental health status of patients with diabetes is crucial. When treating psychological issues and psychiatric disorders, a comprehensive biopsychosocial approach should be taken, and where appropriate, psychopharmacological therapies or psychotherapy should be applied. The goal of continuous education and assistance for self-care is to give individuals with the disease the information and abilities they need to control their condition over time.
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Affiliation(s)
- Polyxeni Mangoulia
- Faculty of Nursing, National and Kapodistrian University of Athens, GR-11527 Athens, Greece;
| | - Charalampos Milionis
- Department of Endocrinology, Diabetes, and Metabolism, Elena Venizelou General Hospital, GR-11521 Athens, Greece;
| | - Eugenia Vlachou
- Department of Nursing, University of West Attica, GR-12243 Athens, Greece;
| | - Ioannis Ilias
- Department of Endocrinology, Hippokration General Hospital, GR-11527 Athens, Greece
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Akyirem S, Ekpor E. Experience of stigma among persons with type 2 diabetes in Africa: a systematic review. Int Health 2024; 16:231-239. [PMID: 37366652 PMCID: PMC11062194 DOI: 10.1093/inthealth/ihad045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/27/2023] [Accepted: 06/06/2023] [Indexed: 06/28/2023] Open
Abstract
Diabetes stigma is a pervasive social phenomenon with significant impacts on individuals living with type 2 diabetes mellitus (T2DM). Despite the negative health impact of diabetes stigma, little is known about the experience of this phenomenon in Africa. This review aimed to synthesize existing quantitative and qualitative studies that examine the experiences and outcomes of T2DM stigma in Africa. A mixed studies review methodology was utilized to conduct this research. Relevant articles were identified by searching the Cumulative Index to Nursing and Allied Health Literature, PubMed, MEDLINE and PsycINFO databases. The mixed method appraisal tool was used to assess the quality of included studies. Of 2626 records identified, 10 articles met the inclusion criteria. The prevalence of diabetes stigma was as high as 70%. The results of the review indicate that individuals with T2DM in Africa are labelled as 'having HIV', 'nearing their death' and 'wasting resources'. These experiences were associated with low quality of life, disease concealment and avoidance of self-management behaviours. The findings highlight the urgent need for further stigma-centric studies to fully understand how T2DM stigma is experienced in Africa. The evidence from such studies would inform the development and evaluation of effective interventions to address this social consequence of T2DM.
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Affiliation(s)
- Samuel Akyirem
- Yale School of Nursing, Yale University, New Haven, Connecticut, 06511, USA
| | - Emmanuel Ekpor
- School of Nursing and Midwifery, University of Ghana, Legon, Accra, Ghana
- Christian Health Association of Ghana, University of Ghana, Legon, Accra, Ghana
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Célind J, Bygdell M, Bramsved R, Martikainen J, Ohlsson C, Kindblom JM. Low birthweight and overweight during childhood and young adulthood and the risk of type 2 diabetes in men: a population-based cohort study. Diabetologia 2024; 67:874-884. [PMID: 38386069 PMCID: PMC10954927 DOI: 10.1007/s00125-024-06101-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/15/2024] [Indexed: 02/23/2024]
Abstract
AIMS/HYPOTHESIS This study aimed to determine the relative contributions of low birthweight and overweight during childhood and young adulthood to the risk of type 2 diabetes in men. METHODS We included 34,231 men born between1945 and 1961 from the population-based BMI Epidemiology Study (BEST) Gothenburg with data on birthweight and overweight status in childhood (8 years, BMI >17.9 kg/m2) and young adulthood (20 years, BMI >25 kg/m2). Participants were followed from age 30 years until 31 December 2019. Information on type 2 diabetes diagnoses was retrieved from Swedish national registers. HRs and 95% CIs for the risk of early (≤59.4 years) and late (>59.4 years) type 2 diabetes were estimated using Cox proportional hazards regression. RESULTS During follow-up, a total of 2733 cases of type 2 diabetes were diagnosed. Birthweight below the median (<3.6 kg) and overweight at age 20 (BMI >25 kg/m2), but not overweight at age 8 (BMI >17.9 kg/m2), were associated with an increased risk of early and late type 2 diabetes. Of note, a birthweight below the median followed by overweight at age 20 years was associated with a substantially increased risk of early type 2 diabetes (HR 6.07, 95% CI 5.08, 7.27), and a low birthweight (≤2.5 kg) combined with overweight at age 20 years was associated with a massive risk of early type 2 diabetes (HR 9.94, 95% CI 6.57, 15.05). CONCLUSIONS/INTERPRETATION Low birthweight and overweight in young adulthood are the major developmental determinants of adult type 2 diabetes risk in men. They contribute in an additive manner to the risk of type 2 diabetes. To reduce the risk of type 2 diabetes, young adult overweight should be avoided, especially in boys with a low birthweight. DATA AVAILABILITY The SPSS analysis code, the R analysis code and a data dictionary have been made available in an online repository ( https://osf.io/bx2as/ ).
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Affiliation(s)
- Jimmy Célind
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
| | - Maria Bygdell
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Rebecka Bramsved
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jari Martikainen
- Bioinformatics and Data Centre, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Claes Ohlsson
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Jenny M Kindblom
- Sahlgrenska Osteoporosis Centre, Centre for Bone and Arthritis Research, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
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9
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Busili A, Kumar K, Kudrna L, Busaily I. The risk factors for mental health disorders in patients with type 2 diabetes: An umbrella review of systematic reviews with and without meta-analysis. Heliyon 2024; 10:e28782. [PMID: 38617916 PMCID: PMC11015102 DOI: 10.1016/j.heliyon.2024.e28782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024] Open
Abstract
Background Patients with type 2 diabetes have a nearly twofold higher rate of diagnosed mental disorders than those without diabetes. The association between type 2 diabetes and mental disorders is well established in the literature and recognized as a bidirectional relationship. This study aims to conduct an umbrella review of risk and protective factors for mental health disorders in patients with type 2 diabetes and assess the credibility of the evidence for the association between each factor and mental health disorders. Methods A comprehensive search was conducted of Medline via PubMed, Web of Science, EMBASE, CINHAL, and PsycINFO from inception to November 17, 2022, to identify systematic reviews with and without meta-analyses examining associations of factors with mental health disorders in patients with type 2 diabetes. For each association, we recalculated the summary effect size and 95% confidence intervals using random-effects models. We also reported the 95% prediction interval and between-group heterogeneity. Results The study included 11 systematic reviews that met the inclusion criteria, comprising eight meta-analyses and three without meta-analyses. This involved approximately 489,930 participants and encompassed 26 unique factors. Six factors were rated as having suggestive evidence at the Class III level. These factors were obesity (n = 18,456, OR 1.75 [1.2 to 2.59], I2 97.7%), neuropathy (n = 3898, OR 2.01 [1.60 to 2.54], I2 44.5%), diabetes complications (n = 1769, OR 1.90 [1.53 to 2.36], I2 39.3%), peripheral blood concentrations of CRP (n = 1742, SMD 0.31 [0.16 to 0.45], I2 84.1%), female sex (n = 35,162, OR 1.36 [1.19 to 1.54], I2 64.5%), and social support (n = 3151, OR 2.02 [1.51 to 2.70], I2 87.2%). Conclusions Several factors associated with mental health disorders in patients with type 2 diabetes were identified with varying degrees of supporting evidence. Significantly, obesity, neuropathy, complications, peripheral blood CRP concentrations, female sex, and social support emerged with suggestive evidence. An investigation of these factors should be conducted to target interventions accordingly. It may be helpful to prioritize patients who have these risk factors as high-risk groups and to implement plans and policies to enhance support before mental health disorders occur.
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Affiliation(s)
- Amani Busili
- College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kanta Kumar
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Laura Kudrna
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Idris Busaily
- Lecture, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
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10
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Pouwer F, Perrin B, Lavender A, Najafi B, Ismail K, Vileikyte L. The quest for wellness: How to optimise self-care strategies for diabetic foot management? Diabetes Metab Res Rev 2024; 40:e3751. [PMID: 38041482 DOI: 10.1002/dmrr.3751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 12/03/2023]
Abstract
Diabetic foot ulceration (DFU) is common and highly recurrent, negatively impacting the individuals' quality of life. The 2023 guidelines of the International Working Group on the Diabetic Foot emphasise that adherence to foot self-care recommendations is one of the most important factors in DFU prevention. These guidelines also briefly mention that depression and other psychosocial problems can hamper treatment and ulcer healing. Moreover, a new clinical question was added on psychological interventions for ulcer prevention, although the evidence regarding the role of psychological and social factors is still limited. To help the field progress, this narrative overview discusses how a stronger focus on psychological factors by both researchers and clinicians could improve the care for people at high DFU risk. The review starts with a testimony of a person living with DFU, explaining that for him, the absence of shared decision-making has been a key barrier to successful foot self-care implementation. Intervention studies that address patient-reported barriers are still scarce, and are therefore urgently needed. Furthermore, the key elements of psychological interventions found to be successful in managing diabetes are yet to be implemented in DFU risk management. Importantly, research evidence indicates that commonly advocated foot self-care recommendations may be insufficient in preventing DFU recurrence, whereas digital technology appears to effectively reduce recurrent DFU. More research is therefore needed to identify determinants of patient acceptance of digital technology.
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Affiliation(s)
- Frans Pouwer
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Steno Diabetes Center Odense (SDCO), Odense, Denmark
- Department of Medical Psychology, Amsterdam UMC, Amsterdam, The Netherlands
| | - Byron Perrin
- La Trobe Rural Health School, La Trobe University - Bendigo Campus, Bendigo, Victoria, Australia
| | | | - Bijan Najafi
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas, USA
| | - Khalida Ismail
- Department of Psychological Medicine, King's College London, Weston Education Centre, London, UK
| | - Loretta Vileikyte
- Diabetes Centre, Manchester Royal Infirmary, Division of Diabetes, Endocrinology and Gastroenterology, School of Medical Sciences, University of Manchester, Manchester, UK
- Department of Endocrinology and Dermatology, University of Miami, Miami, Florida, USA
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11
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Socała K, Żmudzka E, Lustyk K, Zagaja M, Brighenti V, Costa AM, Andres-Mach M, Pytka K, Martinelli I, Mandrioli J, Pellati F, Biagini G, Wlaź P. Therapeutic potential of stilbenes in neuropsychiatric and neurological disorders: A comprehensive review of preclinical and clinical evidence. Phytother Res 2024; 38:1400-1461. [PMID: 38232725 DOI: 10.1002/ptr.8101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 01/19/2024]
Abstract
Neuropsychiatric disorders are anticipated to be a leading health concern in the near future, emphasizing an outstanding need for the development of new effective therapeutics to treat them. Stilbenes, with resveratrol attracting the most attention, are an example of multi-target compounds with promising therapeutic potential for a broad array of neuropsychiatric and neurological conditions. This review is a comprehensive summary of the current state of research on stilbenes in several neuropsychiatric and neurological disorders such as depression, anxiety, schizophrenia, autism spectrum disorders, epilepsy, traumatic brain injury, and neurodegenerative disorders. We describe and discuss the results of both in vitro and in vivo studies. The majority of studies concentrate on resveratrol, with limited findings exploring other stilbenes such as pterostilbene, piceatannol, polydatin, tetrahydroxystilbene glucoside, or synthetic resveratrol derivatives. Overall, although extensive preclinical studies show the potential benefits of stilbenes in various central nervous system disorders, clinical evidence on their therapeutic efficacy is largely missing.
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Affiliation(s)
- Katarzyna Socała
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Maria Curie-Skłodowska University, Lublin, Poland
| | - Elżbieta Żmudzka
- Department of Social Pharmacy, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Klaudia Lustyk
- Department of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Mirosław Zagaja
- Department of Experimental Pharmacology, Institute of Rural Health, Lublin, Poland
| | - Virginia Brighenti
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Anna Maria Costa
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marta Andres-Mach
- Department of Experimental Pharmacology, Institute of Rural Health, Lublin, Poland
| | - Karolina Pytka
- Department of Pharmacodynamics, Faculty of Pharmacy, Jagiellonian University Medical College, Krakow, Poland
| | - Ilaria Martinelli
- Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Jessica Mandrioli
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
- Department of Neurosciences, Azienda Ospedaliero Universitaria di Modena, Modena, Italy
| | - Federica Pellati
- Department of Life Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Giuseppe Biagini
- Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Piotr Wlaź
- Department of Animal Physiology and Pharmacology, Institute of Biological Sciences, Maria Curie-Skłodowska University, Lublin, Poland
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12
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Akar M, Miri K, Mazloum SR, Hajiabadi F, Hamedi Z, Vakilian F, Dehghan H. The impact of cardiopulmonary rehabilitation in phase II cardiac rehabilitation program on the health-related quality of life of patients undergoing coronary artery bypass graft surgery. Curr Probl Cardiol 2024; 49:102221. [PMID: 38000563 DOI: 10.1016/j.cpcardiol.2023.102221] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 11/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND Coronary artery bypass surgery is the leading cause of change in the quality of life and pulmonary function of patients. One strategy to enhance lung muscle strength and improve overall quality of life is pulmonary rehabilitation. This study aimed to investigate the impact of incorporating a pulmonary rehabilitation program into phase II cardiac rehabilitation program on the quality of life of patients undergoing coronary artery bypass graft surgery. METHODS This randomized clinical trial study included 53 patients who underwent coronary artery bypass graft surgery at Imam Reza Hospital in Mashhad between September 2019 and March 2020. The research participants were selected based on specific inclusion criteria and divided into two groups. The control group followed the routine rehabilitation program, whereas the intervention group underwent a pulmonary rehabilitation program for 20-30 min after each session of the cardiac rehabilitation program. Data collection tools included a demographic information questionnaire and the Ferrans and Powers' quality of life index. The data were analyzed using the independent t-test, Mann-Whitney test, paired t-test, Spearman correlation, Wilcoxon test, and SPSS25. RESULTS The mean quality of life score in the intervention group(20.7±1.8) was significantly higher than that of the control group (18.8±2.3)(P < 0.05). Furthermore, the intervention group exhibited significantly higher mean scores in the physical, psychological-spiritual, and family dimensions than the control group(P < 0.05). CONCLUSION The study results demonstrate the positive impact of incorporating a pulmonary rehabilitation program into cardiac rehabilitation on the health-related quality of life of patients undergoing coronary artery bypass graft surgery. TRIAL REGISTRATION IRCT20190707044132N1.
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Affiliation(s)
- Mahjobe Akar
- Department of Medical - Surgical Nursing, School of Nursing and Midwifery (MSC Student), Mashhad University of Medical Sciences, Mashhad, Iran; Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Kheizaran Miri
- Department of Nursing, School of Nursing and Midwifery, Torbat Heydariyeh University of Medical Sciences, Torbat Heydariyeh, Iran
| | - Seyyed Reza Mazloum
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Fatemeh Hajiabadi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Zahra Hamedi
- Department of Cardiac Rehabilitation, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farveh Vakilian
- Vascular Surgery Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Dehghan
- Department of Cardiac Rehabilitation, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
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13
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Jafari A, Moshki M, Ghelichi-Ghojogh M, Nejatian M. Role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting quality of life in type 2 diabetes. Sci Rep 2024; 14:1635. [PMID: 38238365 PMCID: PMC10796649 DOI: 10.1038/s41598-024-51245-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 01/02/2024] [Indexed: 01/22/2024] Open
Abstract
One of the factors that can affect the quality of life is the psychological status of people. Also, the psychological status of individuals can be affected by other variables. Therefore, this study was aimed to determine the role of diabetes health literacy, psychological status, self-care behaviors, and life satisfaction in predicting the quality of life in Iranian patients with type 2 diabetes. This cross-sectional study was conducted in Iran in 2021 among 300 patients with type 2 diabetes. The method of selecting the participants in this study was the proportional stratified sampling method. Data collection instruments included six questionnaires of demographic questionnaire and diabetes status, DASS-21 questionnaire (depression, anxiety, and stress), diabetes health literacy scale, self-care behavior questionnaire, satisfaction with life scale (SWLS), and quality of life questionnaire. Statistical methods such as independent sample t test, one-way analysis of variance, linear regression test, and Pearson correlation were used to analyze the data. Based on the results of Pearson correlation test, there was a positive and significant correlation between diabetes health literacy (r = 0.438, p < 0.001), depression (r = - 0.380, p < 0.001), anxiety (r = - 0.355, p < 0.001), stress (r = - 0.423, p < 0.001), and SWLS (r = 0.265, p < 0.001) with quality of life. Based on the results of linear regression, variables of diabetes health literacy, life satisfaction, self -care behaviors, depression, stress, anxiety, age of onset of diabetes and diabetes duration were able to predict 31% of the quality of life (p < 0.001). The results of this study indicated that diabetes health literacy, life satisfaction, stress and the duration of diabetes are able to predict the quality of life of patients with diabetes. Therefore, it is necessary to pay more attention to these effective variables training programs, especially health literacy, the effect of which is very obvious in this study.
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Affiliation(s)
- Alireza Jafari
- Department of Health Education and Health Promotion, School of Health, Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mahdi Moshki
- Department of Health Education and Health Promotion, School of Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mousa Ghelichi-Ghojogh
- Neonatal and Children's Health Research Center, Department of Biostatistics and Epidemiology, Faculty of Health, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahbobeh Nejatian
- Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran.
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Carreira M, Ruiz de Adana MS, Pinzón JL, Anarte-Ortiz MT. Internet-based cognitive-behavioral therapy is effective in reducing depressive symptomatology in type 1 diabetes: results of a randomized controlled trial. FRONTIERS IN CLINICAL DIABETES AND HEALTHCARE 2023; 4:1209236. [PMID: 38028977 PMCID: PMC10661942 DOI: 10.3389/fcdhc.2023.1209236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023]
Abstract
Objective Depression in people with diabetes is associated with poorer health outcomes. Although web programs integrating cognitive-behavioral therapy with diabetes education have shown good results, no similar approach has been implemented in Spain. This aim of this study was to administer an Internet-based cognitive-behavioral therapy program (CBT) for the treatment of mild-moderate depressive symptomatology in individuals with type 1 diabetes (WEB_TDDI1 study) and evaluate the efficacy of this program. Research design and methods A pre-post randomized controlled study was conducted. The sample comprised 65 people with type 1 diabetes and mild-moderate depressive symptoms: 35 treatment group (TG) and 30 control group (CG). The following effects of the nine-session program were analyzed: depression (Beck Depression Inventory Fast Screen, BDI-FS), metabolic variables (glycosilated hemoglobin, HbA1c), and other psychological variables including anxiety (State Trait Anxiety Inventory, STAI), fear of hypoglycemia (Fear of Hypoglycemia Questionnaire, FH-15), distress (Diabetes Distress Questionnaire (DDS), quality of life (Diabetes Quality of Life Questionnaire, DQOL),and treatment adherence (Diabetes Self-Care Inventory-Revised questionnaire, SCI-R). Results At the end of the treatment program, only 28 people were evaluated (TG=8; CG=20). However, a significant reduction was found in both groups in BDI-FS and STAI-T scores, which was significantly greater in the TG. Significant improvements were also found in the TG in DQOL, FH-15, DDS and SCI-R scores. The percentage change in these variables was also statistically significant in the TG versus the CG. However, no significant results were found in HbA1c. Conclusions The Internet-based cognitive-behavioral therapy program for the treatment of mild-moderate depressive symptomatology in people with type 1 diabetes (WEB_TDDI1 study) is effective in reducing depressive symptomatology in the sample that completed the study. Positive results are also produced in other variables associated with depression in this population such as diabetes-related distress, trait anxiety, fear of hypoglycemia, quality of life, and adherence to diabetes treatment. Although new studies would be necessary to support the results of this platform, the results obtained are positive and support the use of this platform as an appropriate treatment for this population. Clinical trial registration ClinicalTrials.gov; identifier NCT03473704.
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Affiliation(s)
- Mónica Carreira
- Department of Personality, Assessment and Psychological Treatment, Instituto de Investigación Biomedica de Málaga (IBIMA), University of Malaga, Malaga, Spain
| | - Ma Soledad Ruiz de Adana
- Clinical Management Unit of Endocrinology and Nutrition, Instituto de Investigación Biomedica de Málaga (IBIMA), Regional University Hospital, University of Malaga, Malaga, Spain
| | - José Luis Pinzón
- Clinical Management Unit of Endocrinology and Nutrition, Instituto de Investigación Biomedica de Málaga (IBIMA), Virgen de la Victoria University Hospital, University of Malaga, Malaga, Spain
| | - María Teresa Anarte-Ortiz
- Department of Personality, Assessment and Psychological Treatment, Instituto de Investigación Biomedica de Málaga (IBIMA), University of Malaga, Malaga, Spain
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Feldhacker DR, Ikiugu MN, Fritz H, Schweinle WE, Wang H. Habit Formation Intervention to Improve Type 2 Diabetes Self-Management Behaviors: A Feasibility Study. Am J Occup Ther 2023; 77:7706205100. [PMID: 37994806 DOI: 10.5014/ajot.2023.050351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023] Open
Abstract
IMPORTANCE Self-management of lifestyle behaviors is the recommended focus for interventions to address Type 2 diabetes. Habit formation is an effective approach to changing personal behaviors, but evidence of success for Type 2 diabetes is limited. OBJECTIVE To examine the feasibility and preliminary effectiveness of occupation-based habit formation interventions for improving diabetes self-management behaviors. DESIGN Single-subject design with multiple participants providing 4 wk of baseline data followed by 10 wk of intervention data. SETTING Individual telehealth sessions. PARTICIPANTS Eight adults (ages 29-75 yr) with Type 2 diabetes, who had access to a telephone and who were not involved in other diabetes-related education or interventions voluntarily, enrolled into the study. INTERVENTION Participants engaged in 10 wk of habit formation intervention focused on four diabetes self-management domains: nutrition, blood glucose monitoring, medication management, and physical activity. OUTCOMES AND MEASURES Data gathered included findings on measures of diabetes self-care behaviors and habit formation. RESULTS There was a significant change in self-care behaviors for 6 of the 8 participants (p < .05 for 1 participant, and p < .01 for 5 participants). Group changes were statistically significant (p < .001). Habit strength significantly improved for all areas of diabetes self-management (p < .001 for nutrition, blood glucose monitoring, and medication management and p = .001 for physical activity). CONCLUSIONS AND RELEVANCE Findings suggest that the occupation-based intervention was feasible and showed promise for developing self-management behaviors. What This Article Adds: Habits are considered foundational to occupations, yet application of the science of habit formation is often not well understood by occupational therapists. This study considered the theoretical components of habit formation that have been neglected by prior studies and demonstrates the feasibility and preliminary effect estimates of a habit formation intervention when used with people with Type 2 diabetes.
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Affiliation(s)
- Diana R Feldhacker
- Diana R. Feldhacker, PhD, OTD, OTR/L, BCPR, is Founding Program Director and Chair, Department of Occupational Therapy, Des Moines University, Des Moines, IA;
| | - Moses N Ikiugu
- Moses N. Ikiugu, PhD, OTR/L, FAOTA, is Professor, Department of Occupational Therapy, University of South Dakota, Vermillion
| | - Heather Fritz
- Heather Fritz, PhD, OTR/L, CHC, is Founding Program Director, School of Occupational Therapy, Pacific Northwest University, Yakima, WA
| | - William E Schweinle
- William E. Schweinle, PhD, is Professor, Department of Physician Assistant Studies, University of South Dakota, Vermillion
| | - Hongmei Wang
- Hongmei Wang, PhD, is Associate Professor, Department of Health Services Research and Administration, University of Nebraska Medical Center, Omaha
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Aktan R, Yılmaz H, Demir İ, Özalevli S. Agreement between tele-assessment and face-to-face assessment of 30-s sit-to-stand test in patients with type 2 diabetes mellitus. Ir J Med Sci 2023; 192:2173-2178. [PMID: 36456718 PMCID: PMC9715279 DOI: 10.1007/s11845-022-03238-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/21/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND The globalization of healthcare systems, and the aim to lower healthcare costs have all contributed to the growth of telehealth technology in recent years. However, before these systems are put into use, their efficacy should be verified. To the best of our knowledge, this is the first study focusing on the evaluation of functional exercise capacity using the 30-s sit-to-stand (30-s STS) test as a tele-assessment method in patients with type 2 diabetes mellitus (T2DM). AIMS The purpose of the study is to investigate the level of agreement between tele-assessment and face-to-face assessment of 30-s STS test in patients with T2DM. METHODS Fifty participants performed two times 30-s STS tests separated by 1 h: a face-to-face and an Internet-connected video call examination (tele-assessment). Two physiotherapists conduct these evaluations; each was blinded to the other. The order of the evaluations was designated at random for each participant and physiotherapist. RESULTS There was a good level of agreement between tele-assessment and face-to-face assessment of the 30-s STS test (mean differences = 0.20 ± 0.88, limits of agreement = 1.93 to - 1.53). Excellent interrater reliability was found for scores of the 30-s STS test [ICC = 0.93 (95% CI: 0.88; 0.96)]. In addition, all before and after test parameters show that there was a very good interrater reliability (ρ ≥ 0.75). CONCLUSIONS This study shows a good level of agreement between tele-assessment and face-to-face assessment of the 30-s STS test. Our study's findings indicate that tele-assessment is a potential application to determine the level of physical capacity remotely in patients with T2DM.
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Affiliation(s)
- Rıdvan Aktan
- Department of Physiotherapy, Izmir University of Economics, Vocational School of Health Services, Sakarya St. No: 156, 35330, Balcova, Izmir, Turkey.
| | - Hayriye Yılmaz
- Department of Physical Therapy and Rehabilitation, Health Sciences University İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - İsmail Demir
- Department of Internal Medicine, Health Sciences University İzmir Bozyaka Training and Research Hospital, İzmir, Turkey
| | - Sevgi Özalevli
- Faculty of Physical Therapy and Rehabilitation, Dokuz Eylül University, İzmir, Turkey
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Yorke E, Boima V, Ganu V, Tetteh J, Twumasi L, Ekem‐Ferguson G, Kretchy I, Mate‐Kole CC. The mediating role of quality of life on depression and medication adherence among patients with type 2 diabetes mellitus: A cross-sectional study. Health Sci Rep 2023; 6:e1539. [PMID: 37662538 PMCID: PMC10469042 DOI: 10.1002/hsr2.1539] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/27/2023] [Accepted: 08/17/2023] [Indexed: 09/05/2023] Open
Abstract
Background and Aim Patients living with diabetes mellitus have a high burden of psychological distress such as depression and anxiety as well as impaired quality of life, which may negatively impact their adherence to medications, glucose control, and health-related costs.This study assessed the impact of quality of life and depression on medication adherence among patients with type 2 diabetes (type 2 diabetes mellitus [T2DM]) in a tertiary care setting in Ghana. Methods The study was a cross-sectional study involving 238 patients with diabetes aged 18 years and above. Validated tools were used to assess medication adherence, depressive symptoms, and quality of life. Structural Equation Modeling was adopted to examine the mediation effect of quality of life on the relationship between depression and medication adherence among participants. Results The mean age of the participants was 58.82 ± 13.49, and 169 (71.0%) out of a total of 238 respondents were females. Depression had a significant direct relationship with the quality of life of respondents [aβ (95% confidence interval, CI) = -0.20 (-0.03, -0.00), p < 0.05; -0.21 (-0.41, -0.01) p < 0.05, respectively] and indirect relationship with quality of life [aβ (95% CI) = -0.01 (-0.02, -0.004) p < 0.001]. Educational status and religion both showed a significant indirect relationship with quality of life [aβ (95% CI) = 0.06 (0.07, 0.12), p < 0.05; 0.18 (0.01, 0.35) p < 0.05, respectively]. The mediating effect of quality of life on the relationship between depression and medication adherence was significant (Sobel = -3.19, p < 0.001). Conclusion Depression, medication adherence, and quality of life were higher among older adults with T2DM. Depression was also found to have a strong negative association with both medication adherence and quality of life. Interventions to screen for depression and to improve the quality of life in patients living with diabetes are also recommended and this should go beyond the provision of standard treatments to explore further the mechanisms of this relationships.
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Affiliation(s)
- Ernest Yorke
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Boima
- Department of Medicine & Therapeutics, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Vincent Ganu
- Department of Medicine and Cardiothoracic UnitKorle‐Bu Teaching HospitalAccraGhana
| | - John Tetteh
- Department of Community Health, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | | | - George Ekem‐Ferguson
- Department of PsychologyUniversity of GhanaAccraGhana
- National Cardiothoracic CenterKorle Bu Teaching HospitalAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
| | - Irene Kretchy
- Department of PsychologyUniversity of GhanaAccraGhana
| | - Christopher C. Mate‐Kole
- Department of PsychologyUniversity of GhanaAccraGhana
- Department of Psychiatry, University of Ghana Medical School, College of Health SciencesUniversity of GhanaAccraGhana
- Center for Ageing Studies, College of HumanitiesUniversity of Ghana
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Sabag A, Chang CR, Francois ME, Keating SE, Coombes JS, Johnson NA, Pastor-Valero M, Rey Lopez JP. The Effect of Exercise on Quality of Life in Type 2 Diabetes: A Systematic Review and Meta-analysis. Med Sci Sports Exerc 2023; 55:1353-1365. [PMID: 36924331 DOI: 10.1249/mss.0000000000003172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
BACKGROUND Exercise is a proven therapy for managing cardiometabolic risk factors in type 2 diabetes (T2D). However, its effects on patient-reported outcome measures such as quality of life (QoL) in people with T2D remain unclear. Consequently, the primary aim of this study was to determine the effect of regular exercise on QoL in adults with T2D. A secondary aim was to determine the effect of different exercise modalities on QoL. The third aim was to determine whether improvements in QoL were associated with improvements in gly'cated hemoglobin (A1C). METHODS Relevant databases were searched to May 2022. Eligible studies included randomized trials involving ≥2 wk of aerobic and/or resistance exercise and assessed QoL using a purpose-specific tool. Mean differences and 95% confidence intervals (CI) were calculated as standardized mean difference (SMD) or weighted mean difference. A regression analysis was undertaken to examine the interaction between change in QoL with change in A1C. RESULTS Of the 12,642 studies retrieved, 29 were included involving 2354 participants. Exercise improved QoL when compared with control (SMD, 0.384; 95% CI, 0.257 to 0.512; P < 0.001). Aerobic exercise, alone (SMD, 0.475; 95% CI, 0.295 to 0.655; P < 0.001) or in combination with resistance training (SMD, 0.363; 95% CI, 0.179 to 0.548; P < 0.001) improved QoL, whereas resistance training alone did not. Physical components of health-related QoL (HRQoL) improved with all exercise modalities, but mental components of HRQoL remained unchanged. Exercise improved A1C (mean difference, -0.509%; 95% CI, -0.806% to -0.212%; P = 0.001), and this change was associated with improvements in HRQoL ( β = -0.305, SE = 0.140, Z = -2.18, P = 0.030). CONCLUSIONS These results provide robust evidence that regular aerobic exercise alone or in combination with resistance training is effective for improving QoL in adults with T2D. Such improvements seem to be mediated by improvements in physical components of HRQoL and are associated with improved blood glucose control. Further studies should be undertaken to determine the relative importance of exercise duration, intensity, and frequency on patient-reported outcomes such as QoL.
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Affiliation(s)
| | - Courtney R Chang
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, AUSTRALIA
| | - Monique E Francois
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, AUSTRALIA
| | - Shelley E Keating
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
| | - Jeff S Coombes
- Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, AUSTRALIA
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Yang YL, Im EO, Kim Y. Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study. BMC Nurs 2023; 22:237. [PMID: 37430288 DOI: 10.1186/s12912-023-01385-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 06/17/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The prevalence of depression is higher among midlife women, and they have less control over their diabetes during the menopausal transition. However, there is limited evidence on the association between type 2 diabetes mellitus and depression among Korean women in their midlife. This study aimed to examine the association between type 2 diabetes mellitus and depression and explore the levels of awareness and treatment of depression among Korean midlife women with T2DM. METHODS This is a cross-sectional analysis study conducted using data from the Korea National Health and Nutrition Examination Surveys of 2014, 2016, and 2018. Korean women aged 40-64 years who randomly participated in the surveys were included, and 4,063 midlife women were selected as study participants. The diabetes progression status of the participants was classified into diabetes, pre-diabetes, and non-diabetes. Furthermore, the Patient Health Questionnaire-9 was used for screening depression. Participants' awareness rate, treatment rate among incident cases of depression, and treatment rate among awareness cases of depression were also analyzed. For data analysis, the Rao-Scott χ2 test, multiple logistic regression, and linear regression were conducted using SAS 9.4 software program. RESULTS The prevalence of depression significantly differed between diabetes, pre-diabetes, and non-diabetes groups. However, depression awareness, treatment/incident, and treatment/awareness rates did not differ statistically between the diabetes progression status groups. Compared to the non-diabetes group, diabetes group had a higher odds ratio of depression after adjusting for general and health-related factors. Thus, the diabetes group had significantly higher PHQ-9 scores than the non-diabetes group after adjusting for covariates. CONCLUSIONS Women in their midlife who have type 2 diabetes mellitus tend to have higher levels of depressive symptoms and are at risk of depression. However, we found no significant differences between diabetes and non-diabetes regarding the awareness and treatment rates of depression in South Korea. We recommend that future studies focus on developing clinical practice guidelines aimed at additional screening and intervention for depression in midlife women with type 2 diabetes mellitus to ensure prompt treatment and improved outcomes.
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Affiliation(s)
- You Lee Yang
- College of Nursing, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13135, Republic of Korea
| | - Eun-Ok Im
- School of Nursing, Emory University, 1520 Clifton Road, Atlanta, GA, USA
| | - Yunmi Kim
- College of Nursing, Eulji University, 553, Sanseong-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13135, Republic of Korea.
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20
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Mphasha MH, Mothiba TM, Skaal L. Daily living activities' performance by male diabetics with sexual dysfunction in South Africa. Afr J Prim Health Care Fam Med 2023; 15:e1-e6. [PMID: 37526558 PMCID: PMC10476452 DOI: 10.4102/phcfm.v15i1.3885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/11/2022] [Accepted: 01/11/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND Sexual dysfunction (SD) is a common complication among men living with diabetes (MLWD), which adds to stresses induced by medical condition. Effect of stress on their daily living activities has been only poorly described. AIM This study aimed to explore the behaviour and challenges of MLWD experiencing SD in respect of daily living activities. SETTING Five clinics in Senwabarwana in Limpopo province. METHODS Qualitative approach and phenomenological exploratory design were adopted to collect data from 15 male participants selected from five clinics using purposive homogeneous sampling. One-on-one interviews were conducted using voice recorders, and field notes were taken of non-verbal cues. Unstructured interview guide with principal question enabled instructive probing to be conducted. Data were analysed using eight steps of Tesch's inductive, descriptive and open coding technique. RESULTS Participants reported stressful experiences, difficulty coping with diabetes and its accompanying complication of SD that led to fear of losing their wives. They indicated that as a result of stress and difficulty in coping with the condition, they were engaged in less physical activity than before their diagnosis. CONCLUSION Sexual dysfunction is prevalent among male diabetics and often feel stressed and worried about losing their wives. They struggle to cope with conditions to the point where they are less capable of performing tasks than they were before diagnosis. These outcomes are critical issues that should be addressed in any diabetes treatment strategy.Contribution: Support-based collaboration of healthcare providers with spouses and revision of South African diabetes management strategy to incorporate healthy coping strategies are recommended.
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Affiliation(s)
- Mabitsela H Mphasha
- Department of Public Health, Faculty of Healthcare Sciences, University of Limpopo, Polokwane.
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21
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Herbert SL, Flock F, Felberbaum R, Janni W, Löb S, Kiesel M, Schlaiß T, Diessner J, Curtaz C, Joukhadar R, Dayan D, Schwentner L, Singer S, Wöckel A. Predictors of Decreased Quality of Life in Breast Cancer Survivors Five Years After Diagnosis. J Breast Cancer 2023; 26:26.e23. [PMID: 37272248 DOI: 10.4048/jbc.2023.26.e23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 06/06/2023] Open
Abstract
PURPOSE Due to improved therapy, early diagnosis, and growing incidence rates, the number of long-term breast cancer survivors is increasing. Survivors can still be affected by aftercare, resulting in reduced quality of life (QoL). Thus, in this study, we investigated possible predictors of decreased physical and social functioning in breast cancer survivors. METHODS In a German multicenter prospective study, we enrolled 759 female patients with breast cancer before surgery (t1), and contacted them again 5 years after surgery (t4). Data on QoL were assessed at t4 using the European Organization for Research and Treatment of Cancer QoL Core Questionnaire (EORTC QLQ-C30) and its breast cancer module EORTC QLQ-BR23. Predictors of decreased physical and social functioning were analyzed using logistic regression with odds ratios as effect estimates and 95% confidence intervals. Thresholds for the clinical importance of detrimental effects on QoL were defined according to Giesinger. RESULTS Questionnaires from 759 patients were retrieved at t1. Of these, 456 participated in the study at t4. Poor QoL 5 years after diagnosis was reported by 20%-50% of the participants. Age, mastectomy, chemotherapy, education, employment, cohabitation, psychiatric comorbidities at t1, anxiety, depression, and intensity of physical activity emerged as predictors of decreased physical and social functioning 5 years after diagnosis. CONCLUSION Relief of symptoms and improvement in the QoL should be priorities in aftercare. Detecting patients with a decreased QoL is a rising challenge. Healthcare providers should take special care of patients aged 50-59 years, patients with psychiatric comorbidities and depression, and patients who have undergone mastectomy.
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Affiliation(s)
- Saskia-Laureen Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany.
| | - Felix Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - Ricardo Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - Wolfgang Janni
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Sanja Löb
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Matthias Kiesel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Tanja Schlaiß
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Joachim Diessner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Carolin Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Ralf Joukhadar
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - Davut Dayan
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Lukas Schwentner
- Department of Gynaecology and Obstetrics, University Medical Centre Ulm, Ulm, Germany
| | - Susanne Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
| | - Achim Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
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Hsieh HM, Lin CH, Weng SF, Lin PC, Liu TL, Huang CJ. Health-related quality of life, medical resource use and physical function in patients with diabetes mellitus and depression: A cross-sectional analysis from the National Health and Nutrition Examination Survey. J Affect Disord 2023; 327:93-100. [PMID: 36754091 DOI: 10.1016/j.jad.2023.02.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND Patients with either diabetes (DM) or depression (DP) are prone to developing other diseases and require more medical resources than do the general population. This study aimed to examine health-related quality of life, medical resource use, and physical function of patients with both diabetes mellitus and depression, and the magnitude of effects among patients with different combinations of comorbid diseases. METHODS A retrospective cross-sectional study was conducted using the National Health and Nutrition Examination Survey data from 2009 to 2014. Total 16,159 patients were studied and classified into one of 4 groups: both DM and DP(DM+/DP+), DM+/without DP(DP-), without DM (DM-)/DP+, and DM-/DP-, according to the perceived score in Patient Health Questionnaire and diabetes questionnaire in NHANES. Health-related quality of life (HRQoL), medical resource use, and physical function were measured as outcomes of interests. Multivariate logistic regression models were used. RESULTS Compared with DM-/DP- patients, the DM+/DP+ (adjusted odds ratio [AOR]: 2.59; 95 % CI: 1.77-3.80) and DM-/DP+ (AOR: 2.44; 95 % CI: 1.94-3.06) had greater likely to have worse health. In addition, the DM+/DP+ (AOR: 5.40; 95 % CI: 1.30-22.41) and DM+/DP- (AOR: 2.49; 95 % CI: 1.91-3.25) were more likely to have medical visits, and worse physical function. CONCLUSIONS This study found that both depression and diabetes mellitus worsen HRQoL, increase medical resource use, and decrease physical function. Depression status should be considered by clinicians treating diabetes mellitus patients in order to improve their HRQoL, reduce medical resource use, and improve physical function.
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Affiliation(s)
- Hui-Min Hsieh
- Department of Public Health, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Community Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Center for Big Data Research, Kaohsiung Medical University, Kaohsiung, Taiwan; Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ching-Hua Lin
- Kaohsiung Municipal Kai-Syuan Psychiatric Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Post-Baccalaureate Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Shih-Feng Weng
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Healthcare Administration and Medical Informatics, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Pai-Cheng Lin
- Department of Psychiatry, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Ling Liu
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Psychiatry, School of Medicine and Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Jen Huang
- Department of Psychiatry, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Psychiatry, Kaohsiung Medical University Hospital, Taiwan; Department of Psychiatry, School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
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23
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Mund M, Uhlenbusch N, Rillig F, Weiler-Normann C, Herget T, Kubisch C, Löwe B, Schramm C. Psychological distress of adult patients consulting a center for rare and undiagnosed diseases: a cross-sectional study. Orphanet J Rare Dis 2023; 18:82. [PMID: 37060005 PMCID: PMC10103043 DOI: 10.1186/s13023-023-02669-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 03/11/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND Centers for rare diseases serve as contact points for patients with complex, often undiagnosed complaints and persistent somatic symptoms of heterogeneous origin. Little is known about psychological distress of patients consulting these centers. OBJECTIVES To better understand psychological distress of adult patients presenting at a center for rare diseases by determining the proportion of patients screening positive for depressive, anxiety, and somatic symptom disorders (SSD) and to identify factors associated with increased psychopathology. METHODS Cross-sectional data from the routine care registry of the Martin Zeitz Center for Rare Diseases (MZCSE) at the University Medical Center Hamburg-Eppendorf in Germany was retrieved and analyzed. We included all adult patients presenting between October 01,2020 and September 30,2021, who gave written informed consent. MEASURES Sociodemographic variables, medical history and healthcare utilization, as well as validated measures to screen for a depressive disorder (PHQ-8), an anxiety disorder (GAD-7), and SSD (PHQ-15, SSD-12). RESULTS N = 167 patients were included (age 44.5 ± 14.3 years, 64.7% female). A total of 40.7% of the patients screened positive for a depressive disorder (PHQ-8 ≥ 10), 27.5% for an anxiety disorder (GAD-7 ≥ 10) and 45.0% screened positive for SSD (PHQ-15 ≥ 9 & SSD-12 ≥ 23). Factors associated with increased psychopathology included the number of symptoms, the number of different specialties consulted before and past psychotherapy. CONCLUSIONS Patients presenting at centers for rare diseases are likely to experience high rates of psychological distress. Systematically screening patients with rare and undiagnosed diseases for mental disorders can help to detect those at risk at an early stage and initiate adequate psychological care.
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Affiliation(s)
- Meike Mund
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Natalie Uhlenbusch
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Franziska Rillig
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christina Weiler-Normann
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Theresia Herget
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Kubisch
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Bernd Löwe
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany
| | - Christoph Schramm
- Martin Zeitz Center for Rare Diseases, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- 1st Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Sodhi B, Malik M, Agarwal P, Basu S. The prevalence and predictors of depression and disability in older adults and elderly patients with Diabetes in India: Cross-sectional analysis from the Longitudinal Study on Ageing. Diabetes Metab Syndr 2023; 17:102765. [PMID: 37086626 DOI: 10.1016/j.dsx.2023.102765] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 04/08/2023] [Accepted: 04/12/2023] [Indexed: 04/24/2023]
Abstract
AIM Depression is associated with multiple comorbidities, such as Diabetes Mellitus (DM), especially in the geriatric population. Elderly patients having depression-DM comorbidity are more likely to experience disabilities in daily activities (IADL/ADL). The study objective was to determine the prevalence and predictors of depression in elderly patients with DM in India and also report the prevalence of IADL/ADL (Activities of daily living/Instrumental activities of daily living) disabilities in depressed and non-depressed subgroups of patients with DM. METHODS We analyzed the Longitudinal Ageing Study in India (LASI) survey (2017-2018), focusing on individuals aged 45 years and older after excluding those with cognitive impairment. The effective sample size for this study was 66,606. RESULTS Findings indicate that 15.48% of participants had depression while 12.96% (95% CI: 11.04, 15.17) were comorbid for depression and DM. Amongst patients with DM, the prevalence of depression comorbidity was 19.89% (95% CI:16.92, 23.24). On adjusted analysis among patients with DM, urban residence compared to rural, and the availability of financial support was protective against the onset of depression while multimorbidity was a risk factor. CONCLUSIONS Depressive symptoms in the elderly especially with DM comorbidity are linked to a high burden of poor ADL and IADL. Sensitization of the community towards providing support to the elderly and early screening for IADL/ADL disabilities in depression-DM comorbid patients should be prioritized.
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Affiliation(s)
- Baani Sodhi
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India
| | - Mansi Malik
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India
| | | | - Saurav Basu
- Indian Institute of Public Health- Delhi, Public Health Foundation of India, New Delhi, India.
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25
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Tegegne KD, Gebeyehu NA, Kassaw MW. Depression and determinants among diabetes mellitus patients in Ethiopia, a systematic review and meta-analysis. BMC Psychiatry 2023; 23:209. [PMID: 36991387 PMCID: PMC10052826 DOI: 10.1186/s12888-023-04655-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 03/06/2023] [Indexed: 03/31/2023] Open
Abstract
INTRODUCTION Primary studies have estimated the prevalence of depression and its determinants among diabetes patients. However, studies synthesizing this primary evidence are limited. Hence, this systematic review aimed to determine the prevalence of depression and identify determinants of depression among diabetes in Ethiopia. METHODS This systematic review and meta-analysis included a search of PubMed, Google Scholar, Scopus, Science Direct, PsycINFO, and Cochrane library. Data were extracted using Microsoft Excel and analyzed using STATA statistical software (v. 14). Data were pooled using a random-effects model. Forest plots, and Egger's regression test were all used to check for publication bias. Heterogeneity (I)2 was computed. Subgroup analysis was done by region, publication year, and depression screening instrument. In addition, the pooled odds ratio for determinants was calculated. RESULTS Sixteen studies, including 5808 participants were analyzed. The prevalence of depression in diabetes was estimated to be 34.61% (95% CI: 27.31-41.91). According to subgroup analysis by study region, publication year, and screening instrument, the highest prevalence was observed in Addis Ababa (41.98%), studies published before 2020 (37.91%), and studies that used Hospital Anxiety and Depression Scale (HADS-D) (42.42%,) respectively. Older age > 50 years (AOR = 2.96; 95% CI: 1.71-5.11), being women (AOR = 2.31; 95% CI: 1.57, 3.4), longer duration with diabetes (above 5 years) (AOR = 1.98; 95% CI: 1.03-3.8), and limited social support (AOR = 2.37; 95% CI: 1.68-3.34), were the determinants of depression in diabetic patients. CONCLUSION The results of this study suggest that the prevalence of depression in diabetes is substantial. This result underscores the importance of paying particular attention to prevent depression among diabetes. Being older, not attending formal education, longer duration with diabetes, having comorbidity, and low adherence to diabetes management were all associated. These variables may help clinicians identify patients at high risk of depression. Future studies focusing on the causal association between depression and diabetes are highly recommended.
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Affiliation(s)
- Kirubel Dagnaw Tegegne
- Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
| | - Natnael Atnafu Gebeyehu
- Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Wolita Sodo, Ethiopia
| | - Mesfin Wudu Kassaw
- School of Nursing, College of Health Science, Woldia University, Woldia, Ethiopia
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Vergara M, Östgren CJ, Nyström FH, Israelsson H. Sense of vitality is associated with cardiovascular events in type 2 diabetes independently of traditional risk factors and arterial stiffness. Diabet Med 2023; 40:e14938. [PMID: 36039920 PMCID: PMC10947232 DOI: 10.1111/dme.14938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 06/09/2022] [Accepted: 07/26/2022] [Indexed: 01/17/2023]
Abstract
AIMS The aim of this study was to determine if single items in the quality of life questionnaire short form 36 (SF36) were associated with cardiovascular events in patients with type 2 diabetes mellitus (T2DM). METHODS In 756 T2DM patients (260 women) from the CARDIPP study, nine questions from the domains vitality and well-being in SF36 were analysed. Patients, 55-66 years, were recruited in 2005-2008 and followed up until 31 December 2018 for the incidence of major adverse cardiovascular events (MACE), that is, myocardial infarction, stroke or cardiovascular death. RESULTS Median follow-up time: 11.6 years, during which 119 (16%) MACE occurred. The SF36 items: 'seldom full of pep' (HR 1.2, 95% CI: 1.1-1.4, p = 0.006), 'seldom a lot of energy' (HR 1.3, 95%CI: 1.1-1.5, p < 0.001), 'worn out' (HR 1.2, 95%CI: 1.0-1.4, p = 0.020) and 'seldom happy' (HR 1.2, 95%CI: 1.0-1.4, p = 0.012) were independent risk factors for MACE in separate models, as well as male sex, diabetes duration, HbA1c , sagittal abdominal diameter and aortic pulse wave velocity. The variables 'seldom full of pep' and 'seldom a lot of energy' remained associated with MACE when conducting separate analyses for sexes. Only 'seldom a lot of energy' remained associated with MACE when all items from SF-36 were comprised in the same model. CONCLUSIONS One single question regarding energy levels from SF36 may be used as an independent risk factor for cardiovascular events in T2DM patients in primary care, for both men and women. This item may be included in future risk assessment for use in clinical practice for cardiovascular risk stratification of T2DM patients. TRIAL REGISTRATION The study was registered in clinicaltrial.gov (NCT01049737) in 14 January 2010.
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Affiliation(s)
- Marta Vergara
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health SciencesLinköping UniversityLinköpingSweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health SciencesLinköping UniversityLinköpingSweden
| | - Fredrik H. Nyström
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health SciencesLinköping UniversityLinköpingSweden
| | - Hanna Israelsson
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine and Health SciencesLinköping UniversityLinköpingSweden
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Melamed OC, Kalia S, Moineddin R, Greiver M, Kloiber S, Mulsant BH, Selby P, O'Neill BG. Factors Associated With Initiation of Antidepressant Medication in Adults With Type 1 and Type 2 Diabetes: A Primary Care Retrospective Cohort Study in Ontario, Canada. Can J Diabetes 2023; 47:11-18. [PMID: 35933314 DOI: 10.1016/j.jcjd.2022.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/08/2022] [Accepted: 05/23/2022] [Indexed: 01/31/2023]
Abstract
OBJECTIVES Depression in patients with diabetes mellitus is common and associated with poorer outcomes. This study aims to identify demographic, socioeconomic and medical factors associated with the initiation of antidepressant medication after a diagnosis of diabetes in adult patients without a previous prescription for antidepressants. We also examined frequency of primary care visits in the year after antidepressant initiation compared with the year before treatment began. METHODS This was a retrospective cohort study using routinely collected electronic medical record data spanning January 2011 to December 2019 from the University of Toronto Practice-based Research Network (UTOPIAN) Data Safe Haven. Our primary outcome was a first prescription for an antidepressant in patients with diabetes. We used a mixed-effects logistic regression model to identify sociodemographic and medical factors associated with this event. RESULTS Among 22,750 patients with diabetes mellitus, 3,055 patients (13.4%) began taking an antidepressant medication. Increased odds of antidepressant initiation were observed in younger patients (odds ratio [OR], 1.77; 95% confidence interval [CI], 1.39 to 2.26), females (OR, 1.60; 95% CI, 1.46 to 1.7), those receiving insulin treatment (OR, 1.59; 95% CI, 1.43 to 1.78) and cases of polypharmacy (OR, 3.67; 95% CI, 3.29 to 4.11). There was an increase in the mean number of primary care visits from 4.6 to 5.9 per year after antidepressant initiation. CONCLUSIONS In patients with diabetes, age, sex and medical characteristics were associated with the initiation of antidepressants. These patients accessed primary care more frequently. Screening and prevention of depression, particularly in these subgroups, could reduce its personal and systemic burdens.
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Affiliation(s)
- Osnat C Melamed
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Sumeet Kalia
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rahim Moineddin
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Michelle Greiver
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; North York General Hospital, Toronto, Ontario, Canada
| | - Stefan Kloiber
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Benoit H Mulsant
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Peter Selby
- Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Braden G O'Neill
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada; Department of Family and Community Medicine, St. Michael's Hospital, Toronto, Ontario, Canada
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Pérez‐Fernández A, Fernández‐Berrocal P, Gutiérrez‐Cobo MJ. The relationship between well-being and HbA1c in adults with type 1 diabetes: A systematic review. J Diabetes 2023; 15:152-164. [PMID: 36796311 PMCID: PMC9934956 DOI: 10.1111/1753-0407.13357] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 02/18/2023] Open
Abstract
BACKGROUND Diabetes has been associated with psychological problems, which in turn have been related to poorer glycemic control (glycosylated hemoglobin [HbA1c]). On the contrary, psychological well-being constructs have been associated with superior medical outcomes, including better HbA1c. AIM The main objective of this study was to systematically review the existing literature about the relationships between subjective well-being (SWB) and HbA1c in adults with type 1 diabetes (T1D). METHODS Comprehensive searches were conducted in PubMed, Scopus, and Medline, time restricted to 2021, for studies examining the link between HbA1c and the cognitive (CWB) and affective (AWB) components of SWB. A total of 16 eligible studies were selected according to the inclusion criteria, of which 15 measured CWB and 1 AWB. RESULTS Of the 15 studies included, 11 showed a relationship between CWB and HbA1c, with a higher level of HbA1c being related to poorer CWB. The other four studies did not find any significant association. Finally, the only study examining the relationship between AWB and HbA1c found a marginally association between these variables in the expected direction. CONCLUSION The overall data suggest that CWB is negatively related to HbA1c in this population, but these results are inconclusive. This systematic review offers clinical implications, such as the possible evaluation, prevention, and treatment of the problems associated with diabetes through the study and training of the psychosocial variables that may directly influence SWB. Limitations and future lines of investigation are discussed.
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Affiliation(s)
- Aida Pérez‐Fernández
- Department of Basic Psychology, Faculty of PsychologyUniversity of MálagaMálagaSpain
| | | | - María José Gutiérrez‐Cobo
- Department of Developmental and Educational Psychology, Faculty of PsychologyUniversity of MálagaMálagaSpain
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Gonzalez JS, Krause-Steinrauf H, Bebu I, Crespo-Ramos G, Hoogendoorn CJ, Naik AD, Waltje A, Walker E, Ehrmann D, Brown-Friday J, Cherrington A. Emotional distress, self-management, and glycemic control among participants enrolled in the glycemia reduction approaches in diabetes: A comparative effectiveness (GRADE) study. Diabetes Res Clin Pract 2023; 196:110229. [PMID: 36549506 PMCID: PMC9974790 DOI: 10.1016/j.diabres.2022.110229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE We examined emotional distress in relation to metformin adherence, overall diabetes self-management, and glycemic control among adults with early type 2 diabetes (T2DM) enrolled in the GRADE study. METHODS Linear regression models examined cross-sectional associations of baseline depression symptoms and diabetes distress with adherence to metformin, self-management, and HbA1c, adjusting for covariates. Cognitive-affective (e.g., sadness) and somatic (e.g., sleep/appetite disturbance) depression symptoms and diabetes distress subscales were also examined. RESULTS This substudy of 1,739 GRADE participants (56 % Non-Hispanic White, 18 % Non-Hispanic Black, 17 % Hispanic, 68 % male, mean[SD] age = 57.96[10.22] years, diabetes duration = 4.21[2.81] years, and HbA1c = 7.51[0.48]) found that the prevalence of clinically significant depression and diabetes distress was 8.7 % and 25 %, respectively. Fully adjusted models showed that depression symptoms were associated with lower self-management (p < 0.0001); this effect was only significant for somatic symptoms. Diabetes distress was associated with lower adherence (p = 0.0001) and self-management (p < 0.0001); effects were significant for all subscales, except physician-related distress. No significant relationships of total depression symptom severity or diabetes distress with HbA1c were found. CONCLUSIONS Depression symptoms and diabetes distress were robustly associated with problematic diabetes self-management among participants in GRADE. These findings highlight the need for routine assessment of depression symptoms and diabetes distress early in T2DM care.
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Affiliation(s)
- Jeffrey S Gonzalez
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA.
| | - Heidi Krause-Steinrauf
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA
| | - Ionut Bebu
- The Biostatistics Center, Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, The George Washington University, Rockville, MD, USA
| | - Gladys Crespo-Ramos
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Claire J Hoogendoorn
- Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA; Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Aanand D Naik
- School of Public Health, University of Texas Health Science Center, Houston, TX, USA
| | | | - Elizabeth Walker
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA; New York-Regional Center for Diabetes Translation Research, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dominic Ehrmann
- Research Institute Diabetes Academy Mergentheim (FIDAM), Bad Mergentheim, Germany
| | - Janet Brown-Friday
- Department of Medicine (Endocrinology), Albert Einstein College of Medicine, Bronx, NY, USA
| | - Andrea Cherrington
- Department of Medicine (General Internal and Preventive Medicine), University of Alabama, Birmingham, Birmingham, AL, USA
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Paudel S, Khanal SP, Gautam S, Chalise A, Koirala TN, Marahatta SB. Anxiety and depression among people with type 2 diabetes visiting diabetes clinics of Pokhara Metropolitan, Nepal: a cross-sectional study. BMJ Open 2023; 13:e064490. [PMID: 36707109 PMCID: PMC9884930 DOI: 10.1136/bmjopen-2022-064490] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To estimate the prevalence of anxiety and depression and identify the associated factors among people with type 2 diabetes mellitus (T2DM) visiting diabetes clinics of Pokhara Metropolitan, Nepal. DESIGN Cross-sectional study. SETTING Three diabetes clinics in Pokhara Metropolitan, Nepal, from May to July 2021. PARTICIPANTS 283 people with T2DM visiting selected diabetes centres of Pokhara Metropolitan. OUTCOME MEASURES Anxiety and depression were the outcome measures. Face-to-face interviews were conducted using a structured questionnaire comprising information related to participants' sociodemographic profile and several factors along with Hospital Anxiety and Depression-Anxiety subscale and Patient Health Questionnaire-9 to assess the levels of anxiety and depression, respectively. Pearson's Χ2 tests and binary logistic regression were performed to examine association between dependent and independent variables at 5% level of significance. RESULTS The prevalence of anxiety and depression was 31.4% (95% CI 26.2% to 37.5%) and 36.4% (95% CI 30.8% to 42.0%), respectively. Anxiety was found to be associated with a lower level of perceived social support (adjusted OR (AOR) 2.442, 95% CI 1.020 to 5.845), multiple complications (AOR 2.758, 95% CI 1.015 to 7.334) and comorbidities (AOR 2.110, 95% CI 1.004 to 4.436), severe COVID-19 fear (AOR 2.343, 95% CI 1.123 to 4.887) and sleep dissatisfaction (AOR 1.912, 95% CI 1.073 to 3.047). Economical dependency (AOR 1.890, 95% CI 1.026 to 3.482), no insurance (AOR 2.973, 95% CI 1.134 to 7.093), lower perceived social support (AOR 2.883, 95% CI 1.158 to 7.181), multiple complications (AOR 2.308, 95% CI 1.585 to 6.422) and comorbidities (AOR 2.575, 95% CI 1.180 to 5.617), severe COVID-19 fear (AOR 2.117, 95% CI 1.009 to 4.573), alcohol use (AOR 2.401, 95% CI 1.199 to 4.806) and sleep dissatisfaction (AOR 1.995, 95% CI 1.093 to 3.644) were found to be associated with depression. CONCLUSION This study showed high prevalence levels of anxiety and depression among people with T2DM. Strengthening social support and focusing on people with diabetes suffering from comorbidity and complications could help to reduce their risk of mental health problems.
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Affiliation(s)
- Shishir Paudel
- Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
- Department of Public Health, CiST college, Pokhara University, Kathmandu, Nepal
| | | | - Sujan Gautam
- Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
| | - Anisha Chalise
- Center for Research on Environment Health and Population Activities (CREHPA), Kathmandu, Nepal
| | | | - Sujan Babu Marahatta
- Department of Public Health, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal
- Faculty of Science Health and Technology, Nepal Open University, Lalitpur, Nepal
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Fang T, Zhang Q, Wang Z, Liu JP. Bidirectional association between depression and diabetic nephropathy by meta-analysis. PLoS One 2022; 17:e0278489. [PMID: 36538528 PMCID: PMC9767359 DOI: 10.1371/journal.pone.0278489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Studies suggested that the association between depression and diabetic nephropathy may be bi-directional, but this hypothesis remains investigating. In this meta-analysis, the bi-directional relationship between depression and diabetic nephropathy was investigated. METHODS A search for the publications on depression and diabetic nephropathy in the databases of PubMed, Web of science, and Embase from the earliest available to August 2022 was conducted. Two sets of pooled risk estimates were calculated using random effects models: diabetic nephropathy predicting depression and depression predicting diabetic nephropathy. Cross-sectional studies were assessed using Agency for Healthcare Research and Quality (AHRQ), cohort and case-control studies were assessed using Newcastle-Ottawa Scale (NOS). RESULT Of the 974,121 patients in 30 clinical studies, 24 studies met eligibility for diabetic nephropathy predicting onset of depression, representing 28,438 incident cases. The other 6 studies met criteria for depression predicting onset of diabetic nephropathy, representing 945,683 incident cases. The pooled odds ratio (OR) of diabetic nephropathy predicting depression was 1.46 (95% CI 1.27-1.67). The OR of depression predicting diabetic nephropathy was 1.22 (95% CI 1.13-1.31). CONCLUSION This meta-analysis shows that the relationship between depression and diabetic nephropathy may be bidirectional. Diabetic nephropathy may be a predictor of depression, and depression may also be an indicator of diabetic nephropathy. The mechanisms underlying the bidirectional relationship need to be further investigated and interventions of the comorbidity of depression and diabetic nephropathy need be studied in clinical practice.
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Affiliation(s)
- Tingting Fang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- School of Public Health, Hangzhou Normal University, Hangzhou, Zhejiang Province, China
- * E-mail: (TF); (JPL)
| | - Qiuling Zhang
- Department of Endocrinology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang Province, China
| | - Zhiguo Wang
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
| | - Jun-Ping Liu
- Institute of Ageing Research, Hangzhou Normal University, School of Basic Medicine, Hangzhou, Zhejiang Province, China
- Monash University Department of Immunology and Pathology, Central Clinical School, Faculty of Medicine, Prahran, Victoria, Australia
- Hudson Institute of Medical Research, Clayton, Victoria, Australia
- * E-mail: (TF); (JPL)
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Jenkinson E, Knoop I, Hudson JL, Moss‐Morris R, Hackett RA. The effectiveness of cognitive behavioural therapy and third-wave cognitive behavioural interventions on diabetes-related distress: A systematic review and meta-analysis. Diabet Med 2022; 39:e14948. [PMID: 36031793 PMCID: PMC9826380 DOI: 10.1111/dme.14948] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/25/2022] [Indexed: 01/11/2023]
Abstract
AIM Diabetes-related distress is common in diabetes and has implications for well-being. Cognitive behavioural therapy (CBT) and third-wave CBT hold promise as treatments for diabetes-related distress, although previous findings are inconclusive. We aimed to conduct a systematic review with meta-analysis to understand the efficacy of these interventions in treating diabetes-related distress, while also assessing the associative benefits of these interventions on depression, anxiety and glycaemic control. We also aimed to conduct a narrative synthesis, and subgroup analyses to identify intervention components most useful in treating diabetes-related distress. METHOD We searched seven electronic databases from inception to April 2021. Data extraction was independently performed by two reviewers. Methodological quality was assessed. The protocol was registered with the Prospective Register Of Systematic Reviews (PROSPERO): CRD42021240628. RESULTS We included 22 randomised controlled trials investigating the efficacy of CBT and third-wave CBT interventions on diabetes-related distress. CBT for diabetes-related distress significantly reduced distress (SMD = -0.278, p = 0.010) and depression (SMD = -0.604, p = 0.016). Third-wave CBT for diabetes-related distress significantly reduced anxiety (SMD = -0.451, p = 0.034). No significant effect of either intervention on glycated haemoglobin was observed. CBT interventions that included a digital component, were delivered by a psychological practitioner, and included behavioural activation bolstered the effects on diabetes-related distress. CONCLUSIONS CBT aiming to target diabetes-related distress is beneficial for distress and depression. Third-wave CBT for diabetes-related distress is beneficial for anxiety. More work is needed to optimise interventions to improve both mental and physical health outcomes in people with diabetes.
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Affiliation(s)
- Emma Jenkinson
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Iris Knoop
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Joanna L. Hudson
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Rona Moss‐Morris
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
| | - Ruth A. Hackett
- Health Psychology Section, Department of PsychologyInstitute of Psychiatry, Psychology and Neuroscience, King's College LondonLondonUK
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Olaoye DQ, Amusile O, Tonuewa SS, Eseola OA, Ben Ajepe T, Adekoya OF. Diabetes and depression in Africa: Causality, relationship and clinical implications. Ann Med Surg (Lond) 2022; 81:104422. [PMID: 36042924 PMCID: PMC9420496 DOI: 10.1016/j.amsu.2022.104422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 08/12/2022] [Indexed: 11/02/2022] Open
Abstract
The public health threats posed by diabetes and depression individually have been well emphasised globally. However, it is increasingly important to understand these diseases' causes, relationships, and implications in comorbid states. Depression, anxiety, and diabetes are the top 10 causes of disability-adjusted life years (DALYs) in countries worldwide. Several reports have also suggested depression to occur two to three times more frequently in people with diabetes mellitus; with the majority of the cases remaining under-diagnosed, the causes and relationship remain rather complex and understudied. Although the exact link between depression and diabetes is yet to be detailed, quite a number of studies have supported that there is a bidirectional relationship between diabetes and depression. As Pieces of evidence, theories and reports continue to shed more light on the cause and relationship between these two conditions, its implications remain understudied, especially in low-middle-income settings. This commentary draws out the need for intentional screening for depressive symptoms in diabetic patients as early as possible from the implications of its neglect. It is, however, recommended that in the management of diabetes mellitus, emphasis should also be placed on depression as a co-morbidity, just as certain other disease conditions like hypertension and dyslipidaemia are considered.
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Dibb B, Golding SE. A longitudinal investigation of quality of life and negative emotions in misophonia. Front Neurosci 2022; 16:900474. [PMID: 35937869 PMCID: PMC9354518 DOI: 10.3389/fnins.2022.900474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 06/27/2022] [Indexed: 12/01/2022] Open
Abstract
Aims This longitudinal study examined the role of anger, disgust, and anxiety in the experience of misophonia, the quality of life of those with self-reported misophonia in comparison to those without misophonia, and the association of misophonia and quality of life over time. Methods An online longitudinal survey was conducted, with misophonia, anger, disgust, anxiety, depression, self-esteem, and quality of life measured at two time points (6-months apart) in two groups of people (those with self-reported misophonia and those without misophonia). Results Anger and disgust emerged as the primary predictors of misophonic responses. Anxiety and depression were not significantly associated with misophonia over time. Differences in quality of life were observed between those with and without self-reported misophonia in the current study, with lower scores across the SF-36 domains of role limitations due to emotional problems, energy/fatigue, emotional wellbeing, social functioning, and general health for those with misophonia compared to those without misophonia. Compared with other studies, scores for those with self-reported misophonia were lower than those with long-term physical conditions, similar to those with tinnitus, but higher than those with obsessive compulsive disorder. Misophonia was predictive of quality of life over time but only on two domains: role limitations due to emotional problems (predictors: avoidance, emotional responses, and impact on participation in life) and pain (predictor: impact on participation in life). Depression remained a strong predictor of quality of life over time. Conclusion Anger and disgust are more strongly associated with the experience of misophonia than anxiety. Quality of life in people with self-reported misophonia is lower than in the general population and may be similar to those with tinnitus. Depression, avoiding triggers, the extent of the emotional response, and perceived impact on participation in life are associated with perceptions of lower quality of life over time for people with self-reported misophonia.
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Affiliation(s)
- Bridget Dibb
- School of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
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Efthymiadis A, Bourlaki M, Bastounis A. The effectiveness of psychological interventions on mental health and quality of life in people living with type 1 diabetes: a systematic review and meta-analysis. Diabetol Int 2022; 13:513-521. [PMID: 35693990 PMCID: PMC9174393 DOI: 10.1007/s13340-021-00564-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/13/2021] [Indexed: 01/30/2023]
Abstract
Background Living with type 1 diabetes can be associated with significant psychological morbidity, poor glycaemic control, and increased risk for microvascular complications. This systematic review sought to investigate the effects of psychological interventions on depression, anxiety, diabetes-related distress, quality of life, and glycaemic control in people with type 1 diabetes. Methods Eight electronic databases were searched for published and unpublished randomised controlled trials. Screening, data extraction, and risk of bias assessment (using the Cochrane Collaboration tool for assessing risk of bias 2.0) were independently undertaken by two study authors. The results of the studies were meta-analysed, implementing a random-effects model. The Grading of Recommendations Assessment and Development and Evaluation (GRADE) system was used to determine the confidence in the effect estimates. Results Twenty studies were identified. Non-significant standardised mean differences (SMD) were found for depression symptoms (SMD = - 0.17, 95% CI [- 0.41, 0.07], p = 0.16) and diabetes-related distress (SMD = - 0.12, 95% CI [- 0.27, 0.04], p = 0.13). Significant SMD was found for quality of life (SMD = 0.27, 95% CI [0.11, 0.42], p = 0.0007). Significant mean difference (MD) was found for HbA1c (MD = - 0.26, 95% CI [- 0.51, - 0.01], p = 0.04). Prespecified subgroup analysis for cognitive behaviour-based interventions showed significant improvement for HbA1c (MD = - 0.23, 95% CI [- 0.44, - 0.02], p = 0.03). Conclusions Psychological interventions were found to significantly increase quality of life and promote glucose control in people with type 1 diabetes. Depending on their cost-effectiveness, psychological interventions could be incorporated in routine clinical practice for people with type 1 diabetes and concomitant psychological morbidity. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-021-00564-9.
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Affiliation(s)
- Agathoklis Efthymiadis
- Division of General Medicine, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU UK
| | - Marianthi Bourlaki
- Division of Acute General Medicine, John Radcliffe Hospital, Oxford University Hospitals NHS Trust, Oxford, OX3 9DU UK
| | - Anastasios Bastounis
- Division of Epidemiology and Public Health, City Hospital, University of Nottingham, Nottingham, NG5 1PB UK
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Tendolkar I, Polat T, Peters H, Akkermans R, van de Laar F. Commonly occurring adversities in families as risk factors for developing psychosocial and psychiatric morbidities: evidence from general practice. BJPsych Open 2022; 8:e123. [PMID: 35770375 PMCID: PMC9301779 DOI: 10.1192/bjo.2022.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Childhood adversity may lead to mental and somatic complications throughout life. General practitioners are equipped to identify and manage adverse events in households. The relationship between adversities and psychiatric symptoms has not been studied in primary care. AIMS We investigated the relationship of common adversities in families with respect to subsequent development of psychosocial and psychiatric problems in young children. METHOD We analysed data from seven general practices, including participants between 0 and 9 years of age. Adversity was defined as having a household member who was diagnosed with cancer, psychiatric disease or social problems. We compared these patients with controls matched for gender, age and general practice. The primary outcome was any new episode defined with a psychological and psychiatric label. Secondarily, the encounter rates at the general practices after adversity were analysed. RESULTS Participants in both groups were followed for an average of 12 years, whereby patients with an adversity were more likely to develop psychiatric morbidities compared with matched references (odds ratio 1.38, 95% CI 1.12-1.68, P = 0.002), also revealing higher encounter rates at general practices. We found no statistically significant association between adversities in the family and increased psychosocial symptoms. CONCLUSIONS The short- and long-term consequences of exposure to negative events in childhood are of great public health importance. Our data suggest screening more proactively for consequences of commonly occurring adversities in families, as they are a risk factor for subsequent psychiatric symptoms. Enhanced consultation frequency at general practitioners following adversities should be differentiated in more detail.
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Affiliation(s)
- Indira Tendolkar
- Donders Institute for Brain, Cognition and Behavior, Centre for Medical Neuroscience, Department of Psychiatry, Radboud University Nijmegen Medical Center, The Netherlands
| | - Talip Polat
- Department of General Psychiatry, Institute for Mental Health Care Eindhoven (GGzE), The Netherlands
| | - Hans Peters
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
| | - Reinier Akkermans
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
| | - Floris van de Laar
- Department of Primary and Community Care, Radboud University Nijmegen Medical Center, The Netherlands
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Alshehri KM, Althobaiti RA, Alqurashi AI, Algethami NE, Alswat KA. Prevalence of Sexual Dysfunction in Women with Type 1, 2 Diabetes and Thyroid Disorder: A Cross-Sectional Study in Taif City, Saudi Arabia. Int J Womens Health 2022; 14:385-394. [PMID: 35321084 PMCID: PMC8937313 DOI: 10.2147/ijwh.s343065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
Background Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score. Methods A cross-sectional study for female patients who had a routine clinic visits was included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥19 or scored ≥5 on any item or ≥4 on three items were considered to have FSD. Results A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master's degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). Conclusion FSD was highly prevalent in our study population. Those with type 1 diabetes had the highest ASEX scores. We showed non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.
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Affiliation(s)
- Khalid M Alshehri
- Medicine and Endocrinology, AlHada Armed Forced Hospital, Taif, Saudi Arabia
| | - Raghad A Althobaiti
- Obstetrics and Gynecology Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Athar I Alqurashi
- Internal Medicine Department, King Abdulaziz Specialist Hospital, Taif, Saudi Arabia
| | | | - Khaled A Alswat
- Department of Medicine, School of Medicine, Taif University, Taif, 21944, Saudi Arabia
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Stahl-Pehe A, Selinski S, Bächle C, Castillo K, Lange K, Holl RW, Rosenbauer J. Overestimation and underestimation of youths' health-related quality of life are associated with youth and caregiver positive screens for depression: results of a population-based study among youths with longstanding type 1 diabetes. Diabetol Metab Syndr 2022; 14:40. [PMID: 35264222 PMCID: PMC8905804 DOI: 10.1186/s13098-022-00809-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/23/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND This study aimed to analyze the extent and direction of disagreement between self- and proxy-reported quality of life (QoL) and the factors associated with QoL overestimation and underestimation by caregivers compared with self-reports. METHODS This study used data from population-based questionnaire surveys conducted in 2012-2013 and 2015-2016 with 11- to 17-year-olds with a duration of type 1 diabetes of 10 years or longer and their caregivers (n = 1058). QoL in youth was assessed via 10-item KIDSCREEN (KIDSCREEN-10) self- and proxy-reported questionnaires. The scores ranged from 0 to 100, with higher scores indicating better QoL. Depression screening was performed via the Center for Epidemiological Studies Depression Scale for Children for youths (CES-DC screen positive: score > 15) and WHO-5 Well-being Index for parents/caregivers (WHO-5 screen positive: score ≤ 50). RESULTS The mean self- and proxy-reported normalized KIDSCREEN-10 scores were 64.2 (standard deviation [SD] 11.4) and 66.1 (11.5), respectively. More caregivers overestimated (self-reported minus proxy-reported score < - 0.5*SD self-reported score) than underestimated (self-reported minus proxy-reported score > 0.5*SD self-reported score) youths' QoL (37% versus 23%, p < 0.001). Youths who screened positive for depression (18%) were at higher risk of their QoL being overestimated and lower risk of their QoL being underestimated by caregivers than youths who screened negative for depression (RROverestimation 1.30 [95% CI 1.10-1.52], RRUnderestimation 0.27 [0.15-0.50]). Caregivers who screened positive for depression (28%) overestimated the QoL of their children less often and underestimated the QoL of their children more often than caregivers who screened negative for depression (RROverestimation 0.73 [0.60-0.89], RRUnderestimation 1.41 [1.14-1.75]). CONCLUSIONS Caregivers often over- or underestimated their children's QoL. Positive screens for depression among both youths and caregivers contributed to the observed differences between self- and caregiver-reported QoL.
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Affiliation(s)
- Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany.
| | - Silvia Selinski
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Christina Bächle
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Katty Castillo
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Reinhard W Holl
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany
| | - Joachim Rosenbauer
- Institute for Biometrics and Epidemiology, German Diabetes Centre, Leibniz Centre for Diabetes Research, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
- German Centre for Diabetes Research (DZD), Munich-Neuherberg, Auf'm Hennekamp 65, 40225, Düsseldorf, Germany
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Wang T, Liu Y, Huang W. The Association between Serum Neutrophil Gelatinase-Associated Lipocalin and Depression in Patients with Type 2 Diabetes Mellitus. Exp Aging Res 2022; 48:444-454. [PMID: 35142261 DOI: 10.1080/0361073x.2022.2033591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Patients wtih type 2 diabetes mellitus (DM) have an increased risk of depressive symptoms. Whether serum neutrophil gelatinase-associated lipocalin (NGAL) is associated with depressive symptoms in old patients with type 2 DM is still uncertain. OBJECTIVE We aim to investigate whether serum NGAL levels were associated with elevated risk of depressive symptoms in patients with type 2 DM in an old population. METHODS Blood samples from 1012 hospitalized patients were measured for serum NGAL within the first 24 hours after admission. The Center for Epidemiological Studies Depression (CES-D) scale was performed to calculate depressive score. Cox analyses were used to examine the prognostic value of serum NGAL on detecting depressive symptoms during a median period of 5 years (range = 0.3-6.2 years). RESULTS 136 (36.6)% of all subjects have depressive symptoms during the follow-up period. Linear analysis showed that serum NGAL levels at baseline were associated with CES-D score after adjusting for clinically relevant variables in type 2 DM patients (Sβ = 0.118, 95% CI 0.106-0.171, P < .001) but not in non-DM patients (Sβ = 0.025, 95% CI, -0.047-0.083; P = .205). Cox analysis revealed that serum NGAL did have an independent prognostic value on predicting depressive symptoms (HR = 2.247, 95% CI 1.415-3.811, P-trend<0.001, Model 2) in type 2 DM patients but not in non-DM patients (HR = 1.811, 95% CI 1.209-3.292, P-trend = 0.189, Model 2) during follow-up period. CONCLUSIONS We found the first evidence that serum NGAL were strongly associated with depressive symptoms in patients with type 2 DM but not in non-DM patients. Further studies are needed to prove the underlying mechanism for the impact of type 2 DM on the association.
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Affiliation(s)
| | - Yue Liu
- School of Sports Medicine and Rehabilitation, Shandong First Medical University, Shandong, China
| | - Wenwu Huang
- Department of Clinical Psychology, The Affiliated Kangning Hospital of Wenzhou Medical University, wenzhou, China
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Wang L, Yan N, Guo R, Pu L, Dang Y, Pan R, Niu Y. Mediating Role of Depressive Symptoms on the Association Between Neighborhood Social Cohesion and Quality of Life in Individuals with Type 2 Diabetes Mellitus. Patient Prefer Adherence 2022; 16:1085-1092. [PMID: 35479653 PMCID: PMC9037707 DOI: 10.2147/ppa.s354181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/13/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Few studies have explored the association between neighborhood social cohesion (NSC), a type of social capital, and the quality of life of patients with type 2 diabetes mellitus (T2DM). In addition, the potential mechanism for this association remains unclear. The current study examined the mediation effect of depressive symptoms on the relationship between NSC and quality of life among diabetes patients in China. PATIENTS AND METHODS A cross-sectional study of 1747 T2DM patients was conducted. The specific quality of life (DSQL), Center for Epidemiological Survey Depression (CES-D), and social capital scales were administered using a face-to-face survey. Partial correlation analysis and a linear regression model were employed to explore the relationship between NSC, depressive symptoms, and quality of life. Bootstrap analysis using PROCESS was used to test the mediation model. RESULTS After controlling for covariates, NSC was negatively correlated with depressive symptoms (r=-0.24, P<0.01) and DSQL score (r=-0.20, P<0.01) while depressive symptoms were positively correlated with DSQL score (r=0.46, P<0.01). Linear regression analysis also found that NSC was negatively associated with the DSQL score, while depressive symptoms were positively associated with the DSQL score. Depressive symptoms mediated the relationship between NSC and quality of life in T2DM patients (explaining 50.7% of the total variance). CONCLUSION NSC was positively associated with improved quality of life among Chinese T2DM patients in this study, and depressive symptoms were likely to partially explain this relationship. These findings may be used to help maintain a good quality of life among at-risk individuals. Additional prospective studies are needed to confirm these findings.
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Affiliation(s)
- Liqun Wang
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Ning Yan
- Heart Centre & Department of Cardiovascular Diseases, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, 750004, People’s Republic of China
| | - Rongrong Guo
- School of traditional Chinese Medicine, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Lining Pu
- Department of Epidemiology and Statistics, School of Public Health and Management at Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
| | - Yuqi Dang
- Department of Endocrinology, Yinchuan Hospital of Traditional Chinese Medicine, Yinchuan, 750001, People’s Republic of China
| | - Ruiping Pan
- Department of Chinese Medicine, The Second People’s Hospital of Shizuishan, Shizuishan, 753000, People’s Republic of China
| | - Yang Niu
- School of traditional Chinese Medicine, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China
- Correspondence: Yang Niu, Key Laboratory of the Ningxia Ethnomedicine Modernization, Ministry of Education, Ningxia Medical University, Yinchuan, 750004, People’s Republic of China, Tel +8613909574577, Email
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Vaz R, Singh K, Acharya A, Rasania S, Khandekar J. Health-related quality of life and its association with depression in type ii diabetes mellitus patients: A cross-sectional study from Delhi. INDIAN JOURNAL OF MEDICAL SPECIALITIES 2022. [DOI: 10.4103/injms.injms_47_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Abuhegazy H, Mujairi A, Banah F, Agdi Y, Elkeshishi H, Kamel A, Abdullah A, Elsheikh M. Depression and Associated Risk Factors Among Type 2 Diabetic Patients: A Cross Sectional Study on a Convenience Sample from the Diabetic Center, Khamis Mushait; Saudi Arabia. Neuropsychiatr Dis Treat 2022; 18:1975-1984. [PMID: 36072678 PMCID: PMC9442912 DOI: 10.2147/ndt.s374752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 08/20/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Studies had confirmed that diabetic patients have a greater risk for developing depression. Our objectives were to estimate the prevalence and predictors of depression among type 2 diabetic patients. METHODS A cross-sectional study at the Diabetic Center, Armed Forces Hospital-Southern Region (AFHSR), Khamis Mushait was conducted in the period from March to June 2017. The study includes a convenience sample of type 2 diabetic patients. Self-administered questionnaires were utilized. It consists of personal characteristics, diabetes-related information's, and the Arabic version of the Patient Health Questionnaire (PHQ-9). Proper statistical analyses were done to assess the significance of the correlates with p ≤ 0.05 considered significant. RESULTS The study included 350 diabetic patients out of 410 with a response rate of 85.4%. Their age ranged between 28 and 100 years with a mean ±SD of 61.4±13 years. The prevalence of depression among them was 36.6%. Logistic regression revealed that patients older than 50 years were at lower risk for developing depression as compared to those aged between 28 and 40 years OR and 95% CI were 0.21 (0.08-0.57), 0.30 (0.12-0.78) and 0.33 (0.12-0.91) for patients in the age groups 51-60, 61-70 and > 70 years, respectively. Diabetic patients with thyroid dysfunction, neuropathy, those treated with insulin, and noncompliant patients were at double risk for developing depression compared to their counterparts (OR = 2.26, 95% CI = 1.20-4.27, p = 0.012); (OR = 2.35, 95% CI = 1.22-4.53, p = 0.011); (OR = 1.92, 95% CI = 1.08-3.40, p = 0.026); (AOR = 2.14, 95% CI = 1.01-4.53, p = 0.047) respectively. CONCLUSION Almost one third of type 2 diabetic patients were depressed. Younger patients, having comorbid thyroid disorders or neuropathy, those treated with insulin and noncompliant patients were at higher risk for developing depression. Proper screening and treatment of depression is a crucial part of the health care management of diabetic people.
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Affiliation(s)
- Hesham Abuhegazy
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahoud Mujairi
- Department of Family Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Faisal Banah
- Department of Family Medicine, Armed Forces Hospital, Khamis mushait, Saudi Arabia
| | - Yasir Agdi
- Department of Family Medicine, Ministry of Health, Jazan, Saudi Arabia
| | - Heba Elkeshishi
- Department of Psychology, faculty of Arts, El-menia University, Elmenia, Egypt
| | - Ahmed Kamel
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | - Ahmed Abdullah
- Department of Psychiatry, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Elsheikh
- Department of Psychiatry, faculty of Medicine, Al-Azhar University, Cairo, Egypt
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Song X, Zheng Q, Zhang R, Wang M, Deng W, Wang Q, Guo W, Li T, Ma X. Potential Biomarkers for Predicting Depression in Diabetes Mellitus. Front Psychiatry 2021; 12:731220. [PMID: 34912246 PMCID: PMC8667273 DOI: 10.3389/fpsyt.2021.731220] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 11/08/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: To identify the potential biomarkers for predicting depression in diabetes mellitus using support vector machine to analyze routine biochemical tests and vital signs between two groups: subjects with both diabetes mellitus and depression, and subjects with diabetes mellitus alone. Methods: Electronic medical records upon admission and biochemical tests and vital signs of 135 patients with both diabetes mellitus and depression and 187 patients with diabetes mellitus alone were identified for this retrospective study. After matching on factors of age and sex, the two groups (n = 72 for each group) were classified by the recursive feature elimination-based support vector machine, of which, the training data, validation data, and testing data were split for ranking the parameters, determine the optimal parameters, and assess classification performance. The biomarkers were identified by 10-fold cross validation. Results: The experimental results identified 8 predictive biomarkers with classification accuracy of 78%. The 8 biomarkers are magnesium, cholesterol, AST/ALT, percentage of monocytes, bilirubin indirect, triglyceride, lactic dehydrogenase, and diastolic blood pressure. Receiver operating characteristic curve analysis was also adopted with area under the curve being 0.72. Conclusions: Some biochemical parameters may be potential biomarkers to predict depression among the subjects with diabetes mellitus.
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Affiliation(s)
- Xiuli Song
- Clinical Psychology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai, China
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Zheng
- School of Computer and Control Engineering, Yantai University, Yantai, China
| | - Rui Zhang
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Miye Wang
- Information Center, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Deng
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Qiang Wang
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Wanjun Guo
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Ma
- Psychiatric Laboratory and Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, China
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Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182212022. [PMID: 34831779 PMCID: PMC8621394 DOI: 10.3390/ijerph182212022] [Citation(s) in RCA: 65] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022]
Abstract
This review aimed to systematically review observational studies investigating the longitudinal association between anxiety, depression and quality of life (QoL). A systematic search of five electronic databases (PubMed, PsycINFO, PSYNDEX, NHS EED and EconLit) as well as forward/backward reference searches were conducted to identify observational studies on the longitudinal association between anxiety, depression and QoL. Studies were synthesized narratively. Additionally, a random-effects meta-analysis was performed using studies applying the mental and physical summary scores (MCS, PCS) of the Short Form Health Survey. The review was prospectively registered with PROSPERO and a study protocol was published. n = 47 studies on heterogeneous research questions were included, with sample sizes ranging from n = 28 to 43,093. Narrative synthesis indicated that QoL was reduced before disorder onset, dropped further during the disorder and improved with remission. Before onset and after remission, QoL was lower in comparison to healthy comparisons. n = 8 studies were included in random-effects meta-analyses. The pooled estimates of QoL at follow-up (FU) were of small to large effect sizes and showed that QoL at FU differed by disorder status at baseline as well as by disorder course over time. Disorder course groups differed in their MCS scores at baseline. Effect sizes were generally larger for MCS relative to PCS. The results highlight the relevance of preventive measures and treatment. Future research should consider individual QoL domains, individual anxiety/depressive disorders as well as the course of both over time to allow more differentiated statements in a meta-analysis.
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Appel JE, Vrijsen JN, Marchetti I, Becker ES, Collard RM, van Eijndhoven P, Schene AH, Tendolkar I. The Role of Perseverative Cognition for Both Mental and Somatic Disorders in a Naturalistic Psychiatric Patient Sample. Psychosom Med 2021; 83:1058-1066. [PMID: 34419995 DOI: 10.1097/psy.0000000000001003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Perseverative cognition (PC) is the repeated or long-term activation of the cognitive representation of psychological stressors and is associated with prolonged stress including somatic and mental consequences. Hence, PC might represent a cognitive process linking mental and somatic pathology, but current research on this link is limited by investigating healthy samples, markers of somatic disease, and single disorders. The present study explored the importance of PC for different mental and somatic disorders in psychiatric patients. METHODS Data from 260 naturalistic psychiatric outpatients were used. Psychiatric diagnoses were based on structured clinical interviews. Somatic diseases were assessed using a well-validated questionnaire and were clustered into (cardio)vascular and immune/endocrine diseases. PC was operationalized using the Perseverative Thinking Questionnaire (PTQ). RESULTS Multiple regression complemented with relative importance analyses showed that the PTQ total and subscale scores were associated with the presence of mood disorders, addiction, and anxiety. Unexpectedly, no relatively important associations were found between the PTQ and autism spectrum disorder, attention-deficit/hyperactivity disorder, or somatic disease. CONCLUSIONS Our data complement previous work linking PC to stress-related mental disorders but question its immediate role in neurodevelopmental and somatic disorders. Targeting PC in the treatment of mood disorders and perhaps also in addiction seems promising.
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Affiliation(s)
- Judith E Appel
- From the Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour (Appel, Vrijsen, Collard, van Eijndhoven, Schene, Tendolkar), Radboud University Medical Center; Behavioural Science Institute (Appel, Becker), Radboud University; Depression Expertise Centre (Vrijsen), Pro Persona Mental Health Care, Nijmegen, the Netherlands; Department of Life Sciences (Marchetti), Psychology Unit, University of Trieste, Trieste, Italy; and LVR-Klinikum Essen (Tendolkar), Department of Psychiatry and Psychotherapy, University Hospital Essen, Essen, Germany
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Anirudhan T, Mani A, Athira V. Molecularly imprinted electrochemical sensing platform for 2-Aminoadipic acid, a diabetes biomarker. REACT FUNCT POLYM 2021. [DOI: 10.1016/j.reactfunctpolym.2021.105056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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47
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Trendowski MR, Lusk CM, Ruterbusch JJ, Seaton R, Simon MS, Greenwald MK, Harper FWK, Beebe-Dimmer JL, Schwartz AG. Chemotherapy-induced peripheral neuropathy in African American cancer survivors: Risk factors and quality of life outcomes. Cancer Med 2021; 10:8151-8161. [PMID: 34687150 PMCID: PMC8607253 DOI: 10.1002/cam4.4328] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/10/2021] [Accepted: 09/11/2021] [Indexed: 01/12/2023] Open
Abstract
Background Epidemiological studies of chemotherapy‐induced peripheral neuropathy (CIPN) have predominantly focused on non‐Hispanic White patients, despite the observation that African Americans are more likely to experience CIPN. To address this health disparities gap, we sought to identify non‐genetic risk factors and comorbidities associated with CIPN in African American cancer survivors using the Detroit Research on Cancer Survivors study. Methods Logistic regression was used to evaluate relationships between presence of self‐reported CIPN and relevant clinical characteristics in 1045 chemotherapy‐treated African American cancer survivors. Linear regression was used to evaluate risk factors for CIPN and quality of life outcomes that reflect physical, social, emotional, and functional domains of health. Results Patients with CIPN were more likely to report hypertension (OR = 1.28, 95% CI: 0.98–1.67, p = 0.07), hypercholesterolemia (OR = 1.32, 95% CI: 1.001–1.73, p = 0.05), history of depression (OR = 1.62, 95% CI: 1.18–2.25, p = 0.003), and diabetes (OR = 1.33, 95% CI: 0.98–1.82, p = 0.06) after adjustment for age at diagnosis, sex, and cancer site. BMI (OR = 1.02 kg/m2, 95% CI: 1.006–1.04 kg/m2, p = 0.008) was also positively associated with CIPN. In addition, CIPN status was significantly associated with quality of life (FACT‐G total: β = −8.60, 95% CI: −10.88, −6.32) p < 0.0001) and mood (PROMIS® Anxiety: β = 4.18, 95% CI: 2.92–5.45, p < 0.0001; PROMIS® Depression: β = 2.69, 95% CI: 1.53–3.84, p < 0.0001) after adjustment for age at diagnosis, sex, cancer site, and comorbidities. Neither alcohol consumption (OR = 0.88, 95% CI: 0.68–1.14, p = 0.32) nor tobacco use (ever smoked: OR = 1.04, 95% CI: 0.80–1.35, p = 0.76; currently smoke: OR = 1.28, 95% CI: 0.90–1.82, p = 0.18) was associated with increased CIPN risk. Conclusion Risk factor profiles in African Americans are not entirely consistent with those previously reported for non‐Hispanic White patients. Neglecting to understand the correlates of common chemotherapy‐induced toxicities for this patient population may further contribute to the health disparities these individuals face in receiving adequate healthcare.
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Affiliation(s)
- Matthew R Trendowski
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA
| | - Christine M Lusk
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Julie J Ruterbusch
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Randell Seaton
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Michael S Simon
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Mark K Greenwald
- Wayne State University School of Medicine, Department of Psychiatry and Behavioral Neurosciences, Detroit, Michigan, USA
| | - Felicity W K Harper
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Jennifer L Beebe-Dimmer
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Ann G Schwartz
- Wayne State University School of Medicine, Department of Oncology, Detroit, Michigan, USA.,Karmanos Cancer Institute, Detroit, Michigan, USA
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van Dijk SEM, Pols AD, Adriaanse MC, van Marwijk HWJ, van Tulder MW, Bosmans JE. Cost-effectiveness of a stepped care program to prevent depression among primary care patients with diabetes mellitus type 2 and/or coronary heart disease and subthreshold depression in comparison with usual care. BMC Psychiatry 2021; 21:402. [PMID: 34389017 PMCID: PMC8361858 DOI: 10.1186/s12888-021-03367-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Patients with diabetes mellitus type 2 (DM2) and/or coronary heart disease (CHD) are at high risk to develop major depression. Preventing incident major depression may be an important tool in reducing the personal and societal burden of depression. The aim of the current study was to assess the cost-effectiveness of a stepped care program to prevent major depression (Step-Dep) in diabetes mellitus type 2 and/or coronary heart disease patients with subthreshold depression in comparison with usual care. METHODS An economic evaluation with 12 months follow-up was conducted alongside a pragmatic cluster-randomized controlled trial from a societal perspective. Participants received care as usual (n = 140) or Step-Dep (n = 96) which consisted of four sequential treatment steps: watchful waiting, guided self-help, problem solving treatment and referral to a general practitioner. Primary outcomes were quality-adjusted life years (QALYs) and cumulative incidence of major depression. Costs were measured every 3 months. Missing data was imputed using multiple imputation. Uncertainty around cost-effectiveness outcomes was estimated using bootstrapping and presented in cost-effectiveness planes and acceptability curves. RESULTS There were no significant differences in QALYs or depression incidence between treatment groups. Secondary care costs (mean difference €1644, 95% CI €344; €3370) and informal care costs (mean difference €1930, 95% CI €528; €4089) were significantly higher in the Step-Dep group than in the usual care group. The difference in total societal costs (€1001, 95% CI €-3975; €6409) was not statistically significant. The probability of the Step-Dep intervention being cost-effective was low, with a maximum of 0.41 at a ceiling ratio of €30,000 per QALY gained and 0.32 at a ceiling ratio of €0 per prevented case of major depression. CONCLUSIONS The Step-Dep intervention is not cost-effective compared to usual care in a population of patients with DM2/CHD and subthreshold depression. Therefore, widespread implementation cannot be recommended. TRIAL REGISTRATION The trial was registered in the Netherlands Trial Register ( NTR3715 ).
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Affiliation(s)
- S. E. M. van Dijk
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - A. D. Pols
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands ,grid.16872.3a0000 0004 0435 165XDepartment of General Practice and Elderly Medicine and the Amsterdam Public Health research institute, VU University Medical Centre, Amsterdam, The Netherlands
| | - M. C. Adriaanse
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - H. W. J. van Marwijk
- grid.16872.3a0000 0004 0435 165XDepartment of General Practice and Elderly Medicine and the Amsterdam Public Health research institute, VU University Medical Centre, Amsterdam, The Netherlands ,Department of Primary Care and Public Health Medicine, Brighton, UK ,Sussex Medical School, Brighton, UK
| | - M. W. van Tulder
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
| | - J. E. Bosmans
- grid.16872.3a0000 0004 0435 165XDepartment of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam Public Health research institute, De Boelelaan 1085, 1081 HV Amsterdam, the Netherlands
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Catalpol Weakens Depressive-like Behavior in Mice with Streptozotocin-induced Hyperglycemia via PI3K/AKT/Nrf2/HO-1 Signaling Pathway. Neuroscience 2021; 473:102-118. [PMID: 34358633 DOI: 10.1016/j.neuroscience.2021.07.029] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/25/2021] [Accepted: 07/27/2021] [Indexed: 12/15/2022]
Abstract
Depression has huge social risks of high incidence, disability, and suicide. Its prevalence and harm in people with hyperglycemia are 2-3 times higher than in normal people. However, antidepressants with precise curative effects and clear mechanisms for patients with hyperglycemia are currently lacking. Prescriptions containing Rehmannia glutinosa, a traditional medicinal herb with a wide range of nutritional and medicinal values, are often used as antidepressants in Chinese clinical medicine. Catalpol is one of the main effective compounds of R. glutinosa, with multiple biological activities such as hypoglycemia. Here, the antidepressant effect of catalpol on the pathological state of streptozotocin (STZ)-induced hyperglycemia and the underlying molecular mechanisms were analyzed. Results showed that administering catalpol orally to hyperglycemic mice for 21 consecutive days significantly reversed the abnormalities in tail suspension, forced swimming, and open field tests. Catalpol also reversed the abnormal phosphorylation of phosphoinositide 3-kinase (PI3K) and protein kinase B (AKT) and the abnormal levels of nuclear factor erythroid 2-related factor 2 (Nrf2) protein, heme oxygenase-1 (HO-1), and antioxidants, including superoxide dismutase, glutathione peroxidase, glutathione-s transferase, reduced glutathione, and malondialdehyde in the hippocampus and frontal cortex of STZ-induced hyperglycemic mice. Thus, catalpol attenuates depressive-like behavior in pathological hyperglycemic state, and the antidepressant mechanism could at least be partly attributed to the upregulation of the PI3K/AKT/Nrf2/HO-1 signaling pathway in both brain regions, thus restoring the balance between oxidative and antioxidant damage. These data expanded the scientific understanding of catalpol and provided preclinical experimental evidence for its application.
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A novel information sharing framework for people living with type-2 diabetes in the context of a group education program. Health Inf Sci Syst 2021; 9:27. [PMID: 34249351 PMCID: PMC8260345 DOI: 10.1007/s13755-021-00160-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 06/24/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose Online health communities (OHCs) offer opportunities for people with type-2 diabetes to share information and experiences for self improvement. This study is to introduce a novel framework for identifying the potential of online diabetes communities’ practices and outcomes in empowering people living with diabetes. Method : Using a qualitative tradition, we conducted semi-structured interviews with 15 members of these communities, attempting to answer research question: how an online framework for diabetes community can be outlined for empowering patients in their self-management in the context of DGEP. We also analysed 2312 threads shared in the three popular type-2 diabetes Reddit communities (r/diabetes, r/diabetes_t2, and r/type2diabetes) comprising more than 60,000 members.? Results Using thematic analysis, the study identifies three salient themes: (a) Leverage digital health technologies to ubiquitous access, share and integrate resources, (b) Community encouragement in self-care and self-monitoring, and (c) Improve mental well-being by experiencing commonality. Statistically, on average 87% of the participants contended that they would benefit the OHC framework for keeping them interconnected to the program. Furthermore, expert interviews with the healthcare team have been carried out for evaluating the usability and efficiency of the framework. Conclusions The proposed information-sharing framework promotes patients’ self-management of diabetes, revealing that patient participation in diabetes OHC leads to empowering self-management of their diabetes and in turns shedding some light on how healthcare organizations can improve patients’ information behaviour through OHC provisions. This qualitative study suggested that the proposed novel framework is perceived as a useful platform to empower diabetic patients in their self-management, extending value of physical group activities.
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