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Lu Q, Qu L, Xie C, Shu Y, Gao F, Zou M, Fan X, Luo X, Meng J, Xue Y, Cao Y. Relationship between social isolation and glycaemic control of people previously diagnosed with diabetes: secondary analysis from the CHARLS. BMJ Open 2024; 14:e076106. [PMID: 38508640 PMCID: PMC10953297 DOI: 10.1136/bmjopen-2023-076106] [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: 05/28/2023] [Accepted: 01/29/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVES Social isolation may affect diabetes self-management. This study aimed to explore the relations between social isolation and glycaemic control in patients with diabetes and to explore lifestyle differences among individuals with different levels of social isolation. METHODS The relevant data of 665 people previously diagnosed with diabetes included in the China Health and Retirement Longitudinal Study from 2011 to 2015 were extracted and analysed. The study included patient general information, blood glucose, lipids, glycosylated haemoglobin, social isolation index, health-related lifestyle factors and diabetes-related factors. Differences in metabolic abnormalities and modifiable lifestyles were compared among patients with varying levels of social isolation. RESULTS Multiple linear regression analysis demonstrated that among men aged 45-64 years, the high social isolation group had significantly higher glycosylated haemoglobin levels compared with the low isolation group (7.29±1.81 vs 6.59±1.63, p=0.026). A positive correlation was observed between social isolation and blood glucose (β=14.16; 95% CI 2.75 to 25.57; p=0.015) and glycosylated haemoglobin (β=0.35; 95% CI 0.10 to 0.60; p=0.006), indicating that higher social isolation was associated with higher fasting blood glucose and glycosylated haemoglobin levels. However, no significant associations were observed in other age groups. Notably, men aged 45-65 years with high social isolation had higher depression rates (44.10% vs 24.60%, p=0.024), lower engagement in moderate exercise (5.70% vs 23.50%, p=0.019) and shorter 10-minute walks (17.10% vs 36.80%, p=0.027). Differences in other health-related and diabetes-related factors were not statistically significant. CONCLUSION Middle-aged men with diabetes with higher social isolation tend to have higher blood glucose and glycosylated haemoglobin levels. This subset of patients requires targeted attention to provide social support from family and friends for improved glycaemic control. If necessary, education on diabetes should be made available to family members and friends.
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Affiliation(s)
- Qiuping Lu
- Department of Endocrinology, The Sixth Affiliated Hospital ,School of Medicine, South China University of Technology, Foshan City, Guangdong, China
| | - Liyuan Qu
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Cuihua Xie
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi Shu
- Department of Endocrinology, The Sixth Affiliated Hospital ,School of Medicine, South China University of Technology, Foshan City, Guangdong, China
| | - Fang Gao
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Mengchen Zou
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xinzhao Fan
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiangrong Luo
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianfu Meng
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yaoming Xue
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Ying Cao
- Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Hargittay C, Eöry A, Márkus B, Mohos A, Ferenci T, Vörös K, Rihmer Z, Gonda X, Torzsa P. Severity of depressive but not anxiety symptoms impacts glucose metabolism among patients with type 2 diabetes in primary care. Front Med (Lausanne) 2022; 9:944047. [PMID: 35966882 PMCID: PMC9366081 DOI: 10.3389/fmed.2022.944047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 07/04/2022] [Indexed: 11/21/2022] Open
Abstract
Background Data from primary care regarding the prevalence of symptoms of depression and anxiety, and their effect on glycemic control among people with diabetes is lacking in Hungary. The recently introduced Patient Health Record (PHR) requires family doctors to screen for depressive symptoms. Objectives We aimed to investigate the prevalence of depressive and anxiety symptoms among patients with type 2 diabetes in the general practice, and the relationship between these affective disorders and glycated hemoglobin (HbA1c) level. Methods We included 338 consecutive patients with type 2 diabetes from six primary care practices in this cross-sectional study. A self-administered questionnaire (patient history, anthropometric, socioeconomic, laboratory parameters), the Beck Depression Inventory (BDI) and the Hamilton Anxiety Scale (HAM-A) were used. Results The mean age of the sample was 64.0 ± 11.5 (years ± SD), 61% of participants were female. The prevalence of depressive symptoms was 21%, mainly moderate/severe symptoms (13%). Anxiety symptoms were more common (35%). We found significant univariate association between the depressive symptoms and HbA1c (p = 0.001), suicide attempt (p < 0.001), anxiety (p < 0.001), micro- and macrovascular complication (p = 0.028 and p < 0.001), education (p = 0.001) and place of residence (p = 0.002). In multivariate analysis, however, only BDI score had significant (p = 0.03191) association with glycemic control. Conclusion Among primary care patients with type 2 diabetes, the prevalence of depressive symptoms was less frequent than anxiety symptoms. More severe depressive symptoms were associated with worse glycemic control.
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Affiliation(s)
- Csenge Hargittay
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Ajándék Eöry
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Bernadett Márkus
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - András Mohos
- Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Ferenci
- Physiological Controls Research Center, Óbuda University John von Neumann Faculty of Informatics, Budapest, Hungary
- Department of Statistics, Corvinus University of Budapest, Budapest, Hungary
| | - Krisztián Vörös
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Zoltán Rihmer
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
| | - Xenia Gonda
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary
- International Centre for Education and Research in Neuropsychiatry, Samara State Medical University, Samara, Russia
- *Correspondence: Xenia Gonda,
| | - Péter Torzsa
- Department of Family Medicine, Faculty of Medicine, Semmelweis University, Budapest, Hungary
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Mirghani H. The cross talk between chronotype, depression symptomatology, and glycaemic control among sudanese patients with diabetes mellitus: A case-control study. J Family Med Prim Care 2022; 11:330-335. [PMID: 35309608 PMCID: PMC8930107 DOI: 10.4103/jfmpc.jfmpc_656_21] [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: 04/07/2021] [Revised: 07/07/2021] [Accepted: 11/01/2021] [Indexed: 11/09/2022] Open
Abstract
Aim of the Study: There is an increasing awareness about chronotype and depression among patients with diabetes mellitus as commonly ignored serious association. We aimed to investigate the same among patients with type 2 diabetes mellitus and their relation to glycaemic control. Subjects' and Methods: This case-control study conducted at two diabetes centers in Omdurman, Sudan during the period from April 2019 to September 2019. Ninety-two patient with type 2 diabetes and 94 controls signed a written informed consent then interviewed using a structured questionnaire based on the morningness–eveningness scale and the 12-item general health questionnaire; A blood sample was taken for the glycated haemoglobin to assess glycaemic control. The Statistical Package for Social Silences was used for Data analysis. Results: They were 92 patients with diabetes (58.7% women) and 94 healthy control subjects (52.1% women); matched for ages (57.03 ± 8.59 for diabetic patients and 58.46 ± 10.58 years for control subjects) and sex. Morning chronotype was reported in 95.3% vs. 47.5% and intermediate chronotype was evident in 52.4% vs. 4.3% in controls and patients respectively, P < 0.05. Depression symptomatology was found in 76.1% of patients with diabetes vs. 40.4% of control subjects, P < 0.05. No association was shown between depression symptomatology, chronotype, age, sex, and HbA1c, P > 0.05. Conclusion: Sudanese patients with diabetes were more likely intermediate, less morning chronotype, and more depressed compared to their counterparts. No association was found between depression symptomatology and other patient's characters. Larger studies investigating the risk behind depression, chrono-nutrition, and social jetlag among patients with diabetes are needed.
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Lopes A, Roque F, Morgado S, Dinis C, Herdeiro MT, Morgado M. Behavioral Sciences in the Optimization of Pharmacological and Non-Pharmacological Therapy for Type 2 Diabetes. Behav Sci (Basel) 2021; 11:bs11110153. [PMID: 34821614 PMCID: PMC8614941 DOI: 10.3390/bs11110153] [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: 08/02/2021] [Revised: 10/21/2021] [Accepted: 10/25/2021] [Indexed: 11/21/2022] Open
Abstract
Type 2 diabetes mellitus is one of the main chronic diseases worldwide, with a significant impact on public health. Behavioral changes are an important step in disease prevention and management, so the way in which individuals adapt their lifestyle to new circumstances will undoubtedly be a predictor of the success of the treatments instituted, contributing to a reduction in the morbidity and mortality that may be associated with them. It is essential to prepare and educate all diabetic patients on the importance of changing behavioral patterns in relation to the disease, with health professionals assuming an extremely important role in this area, both from a pharmacological and non-pharmacological point of view, and also ensuring the monitoring of the progress of these measures. Diabetes is a chronic disease that requires a high self-management capacity on the part of patients in order to achieve success in treating the disease, and non-adherence to therapy or non-compliance with the previously defined plan, together with an erratic lifestyle, will contribute to failure in controlling the disease. The lower adherence to pharmacological and non-pharmacological treatment in diabetes is mainly correlated to socio-economic aspects, lower health literacy, the side effects associated with the use of antidiabetic therapy or even the concomitant use of several drugs. This article consists of a narrative review that aims to synthesize the findings published in the literature, retrieved by searching databases, manuals, previously published scientific articles and official texts, following the methodology of the Scale for Assessment of Narrative Review Articles (SANRA). We aim to address the importance of behavioral sciences in the treatment of diabetes, in order to assess behavior factors and barriers for behavior changes that have an impact on the therapeutic and non-therapeutic optimization in patients with type 2 diabetes mellitus control.
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Affiliation(s)
- António Lopes
- Pharmaceutical Services of Unity Local of Health of Guarda (ULS da Guarda), 6300-035 Guarda, Portugal; (A.L.); (C.D.)
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), 6200-506 Covilhã, Portugal;
| | - Fátima Roque
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), 6300-559 Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal
- Correspondence:
| | - Sandra Morgado
- Pharmaceutical Services of University Hospital Center of Cova da Beira, 6200-251 Covilhã, Portugal;
| | - Cristina Dinis
- Pharmaceutical Services of Unity Local of Health of Guarda (ULS da Guarda), 6300-035 Guarda, Portugal; (A.L.); (C.D.)
| | - Maria Teresa Herdeiro
- Institute of Biomedicine, Department of Medical Sciences (iBiMED-UA), University of Aveiro, 3810-193 Aveiro, Portugal;
| | - Manuel Morgado
- Health Sciences Faculty, University of Beira Interior (FCS-UBI), 6200-506 Covilhã, Portugal;
- Research Unit for Inland Development, Polytechnic Institute of Guarda (UDI-IPG), 6300-559 Guarda, Portugal
- Health Sciences Research Centre, University of Beira Interior (CICS-UBI), 6200-506 Covilhã, Portugal
- Pharmaceutical Services of University Hospital Center of Cova da Beira, 6200-251 Covilhã, Portugal;
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