RESUMEN
BACKGROUND: This study aimed to synthesize and quantitatively examine Health State Utility Values (HSUVs) for Type 2 Diabetes Mellitus (T2DM) and its complications, providing a robust meta-regression framework for selecting appropriate HSUV estimates. METHOD: We conducted a systematic review to extract HSUVs for T2DM and its complications, encompassing various influencing factors. Relevant literature was sourced from a review spanning 2000-2020, supplemented by literature from PubMed, Embase, and the Web of Science (up to March 2024). Multivariate meta-regression was performed to evaluate the impact of measurement tools, tariffs, health status, and clinical and demographic variables on HSUVs. RESULTS: Our search yielded 118 studies, contributing 1044 HSUVs. The HSUVs for T2DM with complications varied, from 0.65 for cerebrovascular disease to 0.77 for neuropathy. The EQ-5D-3L emerged as the most frequently employed valuation method. HSUV differences across instruments were observed; 15-D had the highest (0.89), while HUI-3 had the lowest (0.70) values. Regression analysis elucidated the significant effects of instrument and tariff choice on HSUVs. Complication-related utility decrement, especially in diabetic foot, was quantified. Age <70 was linked to increased HSUVs, while longer illness duration, hypertension, overweight and obesity correlated with reduced HSUVs. CONCLUSION: Accurate HSUVs are vital for the optimization of T2DM management strategies. This study provided a comprehensive data pool for HSUVs selection, and quantified the influence of various factors on HSUVs, informing analysts and policymakers in understanding the utility variations associated with T2DM and its complications.
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Diabetes Mellitus Tipo 2 , Humanos , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/complicaciones , Estado de Salud , Calidad de Vida , Complicaciones de la Diabetes/psicología , Años de Vida Ajustados por Calidad de Vida , Análisis de RegresiónRESUMEN
BACKGROUND: Diabetes complications are prevalent in people with diabetes, causing considerable individual suffering and increased health costs. However, the relationships of multidimensional, modifiable, and nonmodifiable factors to diabetes complications and the role of diabetes distress have been rarely examined. OBJECTIVE: The aims of this study were to examine the associations of age, sex, knowledge, self-efficacy, self-compassion, resilience, self-esteem, depressive symptoms, diabetes distress, social support, and body mass index with diabetes complications and to investigate the mediating role of diabetes distress. METHODS: In this cross-sectional, correlational study, data on all study variables were collected from 148 people with diabetes through REDCap in 2023. Multiple regression analysis and the PROCESS macro for SPSS were used to address the aims. RESULTS: Older age and higher levels of diabetes distress were associated with more diabetes complications. Depressive symptoms were associated with diabetes distress; and diabetes distress, but not depressive symptoms, was associated with diabetes complications, controlling for all other variables. CONCLUSIONS: Depressive symptoms and diabetes distress were directly or indirectly associated with diabetes complications, and diabetes distress was a mediator in the relationship between depressive symptoms and diabetes complications. Health care providers can target reduction of depressive symptoms and diabetes distress to reduce diabetes complications.
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Complicaciones de la Diabetes , Humanos , Estudios Transversales , Masculino , Femenino , Persona de Mediana Edad , Complicaciones de la Diabetes/psicología , Complicaciones de la Diabetes/complicaciones , Depresión/psicología , Anciano , Encuestas y Cuestionarios , Adulto , Apoyo Social , Autoeficacia , Índice de Masa CorporalRESUMEN
BACKGROUND: Complications of diabetes in women have adverse effects on their self-image, quality of life, health, and other social relationships, thereby leading to sexual dysfunction. maternity nurse care can play a critical role in assessing the knowledge about needs for sexual health. AIM: The present study aims to evaluate the effect of the counseling model on female patients with diabetes regarding sexual dysfunction. METHOD: A quasi-experimental research design was used to conduct the study at the diabetic and obstetric outpatient clinic in 2 hospitals (Al Salam Port Said General Hospital, Elzohor General Hospital), and in five centers in Port Said City (El-Kuwait Center, Othman Ibnafan Center, El-arab 1 center, El-manakh center, El-arab2 center). A purposive sample of 178 female diabetic patients was included in the study. Two tools were used for collecting data consisted of; (1 interview questionnaire sheet) including personal characteristics, medical history, and present sexual problem of the studied female patients, (and 2 female sexual function index (FSFI). RESULTS: the current study revealed that there was a high statistical difference between female sexual function in post with mean ± SD (23.3 ± 4.1) compared to pre-educational intervention with mean ± SD (19.5 ± 3.7), while there was a high statistically significant difference among pre- & post-program application regarding female sexual function index (p > 0.001). CONCLUSION: the counseling model had a positive effect in improving the sexual function among female patients with diabetes. TRIAL REGISTRATION NUMBER (TRN): The study protocol was approved by the Research Ethics Committee of the Faculty of Nursing, Port Said University (code number: NUR 12/9/2021-6).
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Consejo , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Adulto , Disfunciones Sexuales Fisiológicas/psicología , Persona de Mediana Edad , Encuestas y Cuestionarios , Disfunciones Sexuales Psicológicas/psicología , Complicaciones de la Diabetes/psicologíaRESUMEN
PURPOSE: The purpose of this study was to assess the knowledge, attitudes, and practices among providers and patients regarding hearing impairment and screening referrals in people with diabetes. METHODS: A cross-sectional survey design among health care providers and patients at an academic medical center in Oklahoma was used to gather knowledge, attitudes, and practices data. RESULTS: Only 25.6% of providers selected hearing impairment as a complication of diabetes, whereas 96.7% selected retinopathy, kidney dysfunction, and foot infection. Reported barriers to referring patients for hearing impairment screenings were being unfamiliar with recommended screening frequency (57.3%) and existence of higher priorities (35.4%). When asked to select parts of the body affected by diabetes, 21.0% of patients surveyed selected ears, 88.0% selected feet, and 85.0% selected eyes and kidneys. Fewer patients reported being told hearing impairment is a complication of diabetes compared to retinopathy (8.1% vs 85.9%). Additionally, 24.2% of patients reported having a hearing impairment screening, and 96.0% reported having a dilated eye exam. CONCLUSIONS: Most providers and patients at an academic medical center are unaware of the relationship between diabetes and hearing impairment. Providers reported there are several barriers that need to be overcome to refer patients to audiologists.
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Conocimientos, Actitudes y Práctica en Salud , Pérdida Auditiva , Humanos , Estudios Transversales , Masculino , Femenino , Pérdida Auditiva/epidemiología , Persona de Mediana Edad , Adulto , Anciano , Personal de Salud/psicología , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/psicología , Oklahoma/epidemiología , Derivación y Consulta , Tamizaje MasivoRESUMEN
This study aims to explore the relationship among diabetes-related distress, social-ecological support, and self-management behavior in older adults with type 2 diabetes mellitus (T2DM) and chronic complications. This cross-sectional study included older adults with T2DM in Shanghai, China, between January and July 2022. The problem areas in diabetes scale (PAID), the chronic illness resource survey (CIRS), and the diabetes self-management behavior for older (DSMB-O) were employed. A total of 264 participants (157 [59.47%] males, aged 71.07 ± 6.47 years) were included; their T2DM duration ranged from 5 to 30 years, with an average of 11.19 ± 6.96 years. The DSMB-O scores were negatively correlated with the PAID scores and positively correlated with CIRS scores. The CIRS scores were negatively correlated with the PAID scores. CIRS had a positive direct effect on DSMB-O, and CIRS had an indirect effect on DSMB-O through PAID. CIRS had a total effect on DSMB-O through PAID. The mediating effect made up 28.89% of the total effect. In older adults with T2DM and chronic complications, chronic illness resources were correlated with diabetes-related distress and self-management behavior. Chronic illness resources had both a direct effect on self-management behavior and an indirect effect through diabetes-related distress.
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Diabetes Mellitus Tipo 2 , Automanejo , Estrés Psicológico , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , China/epidemiología , Enfermedad Crónica/psicología , Estudios Transversales , Complicaciones de la Diabetes/psicología , Diabetes Mellitus Tipo 2/psicología , Diabetes Mellitus Tipo 2/terapia , Autocuidado/psicología , Automanejo/métodos , Automanejo/psicología , Apoyo Social , Estrés Psicológico/psicología , Estrés Psicológico/etiología , Persona de Mediana EdadRESUMEN
AIMS: This study aimed to explore the health-related quality of life and the various demographics and clinical characteristics associated with it among people with type 2 diabetes mellitus in Bangladesh. METHODS: A total of 1253 participants with type 2 diabetes were recruited from a cross-sectional and retrospective study conducted in Bangladesh in 2017. Participants were recruited from six rural and urban diabetes hospitals. The health-related quality of life of the participants was assessed using the validated EuroQol-5D-5L scale and EuroQol-VAS score. Information was collected via face-to-face interviews and existing medical records. Data was analysed using univariate and multivariable regression analyses with bootstrap resampling. RESULTS: The average health-related quality of life was 0.64 (±0.20) for EQ-5D-5L score and 61.69 (±34.98) for EQ-VAS score. Old age, low income, low education level, residing in an urban area, longer duration of diabetes, being physically inactive, the presence of macro- and/or micro-vascular complications, impaired cognitive function, being depressed and having anxiety were related to poor health-related quality of life. CONCLUSION: The health-related quality of life among people with type 2 diabetes in Bangladesh is low, and various socio-demographic and psychological factors and diabetes-related complications are associated with it. This finding will help reform treatments and enforce lifestyle modifications to ensure that the burden of diabetes on people's quality of life is minimal.
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Ansiedad/epidemiología , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus Tipo 2/fisiopatología , Estado de Salud , Calidad de Vida , Adulto , Ansiedad/psicología , Bangladesh/epidemiología , Glucemia/análisis , Estudios Transversales , Complicaciones de la Diabetes/psicología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Factores Socioeconómicos , Encuestas y CuestionariosAsunto(s)
Diabetes Mellitus/psicología , Diabetes Mellitus/terapia , Adulto , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/etiología , Disfunción Cognitiva/terapia , Demencia/epidemiología , Demencia/etiología , Demencia/terapia , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Complicaciones de la Diabetes/terapia , Diabetes Mellitus/epidemiología , Alemania/epidemiología , Humanos , Educación del Paciente como Asunto/métodos , Educación del Paciente como Asunto/normas , Funcionamiento Psicosocial , Intervención Psicosocial/métodos , Intervención Psicosocial/organización & administración , Intervención Psicosocial/normas , Automanejo/educación , Automanejo/métodos , Apoyo Social/métodosAsunto(s)
Congresos como Asunto , Diabetes Mellitus/terapia , Endocrinología , Adolescente , Automonitorización de la Glucosa Sanguínea/métodos , Automonitorización de la Glucosa Sanguínea/tendencias , COVID-19/sangre , COVID-19/complicaciones , COVID-19/epidemiología , COVID-19/terapia , Niño , Preescolar , Congresos como Asunto/historia , Congresos como Asunto/tendencias , Comparación Transcultural , Diversidad Cultural , Países en Desarrollo , Complicaciones de la Diabetes/sangre , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Complicaciones de la Diabetes/terapia , Diabetes Mellitus/sangre , Diabetes Mellitus/epidemiología , Diabetes Mellitus/psicología , Dieta , Dislipidemias/complicaciones , Dislipidemias/epidemiología , Dislipidemias/terapia , Endocrinología/historia , Endocrinología/métodos , Endocrinología/organización & administración , Endocrinología/tendencias , Femenino , Historia del Siglo XXI , Humanos , Masculino , Obesidad/complicaciones , Obesidad/epidemiología , Obesidad/terapia , Sociedades Médicas/historia , Sociedades Médicas/organización & administración , Sociedades Médicas/normas , Sociedades Médicas/tendencias , Adulto JovenRESUMEN
BACKGROUND: It is well known that diabetes mellitus (DM) affects health-related quality of life (HRQOL) in both younger (aged 18-64 years) and older adults (aged ≥ 65 years). However, to date, no study has compared HRQOL and its predictors between younger and older adults with DM in Indonesia. Such a comparison is important because the results can guide nurses and clinicians to establish evidence-based educational programs that are specific and suitable for patients. Therefore, the aim of this study was to investigate the difference in HRQOL and its predictors in younger and older adults with DM in Indonesia. METHODS: A cross-sectional study was conducted on 641 patients with type 2 diabetes mellitus (T2DM) who were recruited via simple random sampling from 16 primary health centers in Banyumas Regency, Indonesia. A self-administered questionnaire containing the Summary of Diabetes Self-Care Activities, the DDS17 Bahasa Indonesia, the Beck Depression Inventory II, the Self-Efficacy for Diabetes Scale, the Family APGAR, and the 36-item Short-Form Health Survey was used to measure diabetes self-management (DSM), diabetes distress (DD), depression, self-efficacy, family support, and HRQOL, respectively. Independent t-tests were used to compare the physical component summary (PCS) and mental component summary (MCS) scores between younger and older adults with T2DM. Hierarchical multiple regression analyses were used to examine the factors associated with HRQOL in both groups. RESULTS: PCS scores were significantly different between the two groups. Older adults reported lower PCS scores than younger adults. No differences between the two groups were observed in the MCS scores. The hierarchical multiple regression analysis showed that level of education, employment status, number of diabetes-related complications, DSM, DD, depression, and self-efficacy were significant predictors of HRQOL in younger adults, while income, depression, DD, and self-efficacy were significant predictors of HRQOL in older adults. DD was the strongest predictor of HRQOL in younger adults, and depression was the strongest predictor in older adults. CONCLUSION: Older adult patients had lower PCS scores than younger adult patients. This study is the first to show that the predictors of HRQOL differ between younger and older adults with T2DM. It provides insights for nurses and clinicians in Indonesia to establish evidence-based, age-specific educational programs.
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Envejecimiento/psicología , Complicaciones de la Diabetes/psicología , Diabetes Mellitus Tipo 2/psicología , Calidad de Vida/psicología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Complicaciones de la Diabetes/epidemiología , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Indonesia/epidemiología , Masculino , Persona de Mediana Edad , Análisis Multivariante , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Quality of life and self-efficacy assessments are increasingly applied in research with type 2 diabetes mellitus patients due to the impact of the disease on their lives. This study aimed to describe the quality of life and self-efficacy in type 2 diabetes mellitus patients and describe the association of quality of life and self-efficacy with demographic, metabolic, and clinical variables. This is a secondary data analysis from a cross-sectional study: Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country. Data were obtained by standardized interviews and evaluation of medical records. The evaluation tools used were the Diabetes 39 questionnaire (D-39) to measure the quality of life and the General Self-Efficacy scale (GSE) for self-efficacy. The median scores of the D-39 and GSE were 34.6 and 34, respectively. The D-39 dimension with the highest score was anxiety and concern. Better quality of life was associated with being older than 65 years old, not having complications, and the absence of depression. No significant association was found between self-efficacy and the quality of life score. Results suggest patients with type 2 diabetes mellitus have a poor quality of life. Patient-centered strategies for type 2 diabetes mellitus care must consider these psychosocial factors to improve disease control and quality of life.
La calidad de vida y la evaluación de autoefiacia se aplican cada vez más en la valoración de los pacientes con diabetes mellitus tipo 2 debido al alto impacto de la enfermedad en sus vidas. Este estudio tiene como objetivo describir la calidad de vida y autoeficacia en pacientes con diabetes mellitus tipo 2 y describir la asociación de calidad de vida y autoeficacia con variables demográficas, metabólicas y clínicas. Este estudio es un análisis secundario del estudio transversal: Control metabólico en pacientes con diabetes mellitus tipo 2 en un hospital público del Perú: estudio de corte transversal en un país de bajos y medianos ingresos. Los datos se obtuvieron mediante cuestionarios estandarizadas y evaluación de historias clínicas. Las herramientas de evaluación utilizadas fueron el cuestionario Diabetes -39 (D-39) para medir la calidad de vida y la escala de autoeficacia general para medir autoeficacia (GSE). Las medias del D-39 y GSE fueron 34,6 y 34, respectivamente. La dimensión con la puntuación más alta del D-39 fue "ansiedad y preocupación". Una mejor calidad de vida estuvo asociada con ser mayor de 65 años, no tener complicaciones microvasculares y la ausencia de depresión. No se encontró una asociación significativa entre la autoeficacia y calidad de vida. Los resultados sugieren que los pacientes con diabetes mellitus tipo 2 tienen una pobre calidad de vida. Las estrategias centradas en el cuidado del paciente con diabetes mellitus tipo 2 deben considerar estos factores psicosociales para mejorar el control de la enfermedad y la calidad de vida.
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Complicaciones de la Diabetes/psicología , Diabetes Mellitus Tipo 2/psicología , Calidad de Vida/psicología , Autoeficacia , Anciano , Estudios Transversales , Diabetes Mellitus Tipo 2/etnología , Hospitales Públicos , Humanos , Perú , Encuestas y CuestionariosRESUMEN
AIMS/INTRODUCTION: To estimate preference-based measures of health-related quality of life associated with sociodemographic and clinical characteristics in type 2 diabetes patients. MATERIALS AND METHODS: Individuals with EuroQol-5 dimensions-3 levels data were identified from Taiwan's National Health Interview Survey in 2009 and 2013. Status of diabetes, comorbidities, complications and treatments were ascertained through data linkage to Taiwan's National Health Insurance Research Database. Multivariable ordinary least squares, Tobit and median regression analyses were used to estimate the coefficients that represented independent impacts of patients' characteristics on health-related quality of life. RESULTS: The mean health utility score for 2,104 participants was 0.838. Being female, aging, divorced/widowed, never worked or underweight, or having a lower monthly household income, injectable glucose-lowering therapy, comorbid connective tissue disease or depression were associated with lower health utilities. Having an amputation led to the largest reduction by 0.288 in health utilities, followed by debilitating stroke (0.266), heart failure (0.237), other coronary heart disease (0.185), kidney dialysis/transplant (0.148), coronary revascularizations (0.093), transient ischemic attack/stroke (0.078), diabetic neuropathy (0.062), polyneuropathy (0.055) and other neuropathy (0.043). CONCLUSIONS: Major vascular complications, connective tissue disease and depression are associated with considerably worse health-related quality of life. These health utility estimates can facilitate health economic evaluations to determine cost-effective strategies for diabetes management.
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Bases de Datos Factuales/estadística & datos numéricos , Complicaciones de la Diabetes/patología , Diabetes Mellitus Tipo 2/fisiopatología , Estado de Salud , Calidad de Vida , Factores Socioeconómicos , Adulto , Anciano , Comorbilidad , Estudios Transversales , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Femenino , Estudios de Seguimiento , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pronóstico , Encuestas y Cuestionarios , Taiwán/epidemiología , Adulto JovenRESUMEN
CONTEXT: Lacunar strokes and diabetes are risk factors for cognitive dysfunction. Elucidating modifiable risk factors for cognitive dysfunction has great public health implications. One factor may be glycemic status, as measured by glycated hemoglobin (A1c). OBJECTIVE: The aim of this study was to assess the relationship between A1c and cognitive function in lacunar stroke patients with diabetes. METHODS: The effect of baseline and follow-up A1c on the baseline and the change in Cognitive Assessment Screening Instrument (CASI) score over time among participants with a median of 2 cognitive assessments (range, 1-5) was examined in 942 individuals with diabetes and a lacunar stroke who participated in the Secondary Prevention of Small Subcortical Strokes (SPS3) trial (ClinicalTrials.gov No. NCT00059306). RESULTS: Every 1% higher baseline A1c was associated with a 0.06 lower standardized CASI z score (95% CI, -0.101 to -0.018). Higher baseline A1c values were associated with lower CASI z scores over time (P for interactionâ =â .037). A 1% increase in A1c over time corresponded with a CASI score decrease of 0.021 (95% CI, -0.0043 to -0.038) during follow-up. All these remained statistically significant after adjustment for age, sex, education, race, depression, hypertension, hyperlipidemia, body mass index, cardiovascular disease, obstructive sleep apnea, diabetic retinopathy, nephropathy insulin use, and white-matter abnormalities. CONCLUSION: This analysis of lacunar stroke patients with diabetes demonstrates a relationship between A1c and change in cognitive scores over time. Intervention studies are needed to delineate whether better glucose control could slow the rate of cognitive decline in this high-risk population.
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Cognición , Diabetes Mellitus/metabolismo , Diabetes Mellitus/psicología , Glucosa/metabolismo , Accidente Vascular Cerebral Lacunar/metabolismo , Accidente Vascular Cerebral Lacunar/psicología , Anciano , Complicaciones de la Diabetes/metabolismo , Complicaciones de la Diabetes/psicología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Accidente Vascular Cerebral Lacunar/complicacionesRESUMEN
Stroke is one of the leading causes of mortality and the leading cause of long-term disability worldwide. Although cognitive impairment is a common consequence of stroke, the underlying pathophysiological processes that lead to it are still poorly understood. Recently, more studies have shown evidence of the involvement of diabetes in producing a chronic neuroinflammatory state, which ultimately alters the recovery of function and cognition after stroke. To better understand the impact of diabetes on poststroke recovery, here we highlight the recent insights on the role of diabetes in neuroinflammation, especially regarding its effect on microglial function, and the emerging data on the involvement of kinins in both diabetes and neuroinflammation.
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Bradiquinina/metabolismo , Encéfalo/metabolismo , Cognición , Disfunción Cognitiva/etiología , Complicaciones de la Diabetes/etiología , Microglía/metabolismo , Animales , Encéfalo/patología , Encéfalo/fisiopatología , Disfunción Cognitiva/metabolismo , Disfunción Cognitiva/patología , Disfunción Cognitiva/psicología , Complicaciones de la Diabetes/metabolismo , Complicaciones de la Diabetes/patología , Complicaciones de la Diabetes/psicología , Humanos , Microglía/patología , Receptores de Bradiquinina/metabolismo , Transducción de SeñalRESUMEN
BACKGROUND: Various primary studies have been conducted in sub-Saharan countries on the level of health related quality of life (HRQoL) and their associated factors among diabetic patients. However, the result of these studies lacks consistency. Therefore, this systematic review and meta-analysis estimates the pooled level of HRQoL and their associated factors among diabetic patients in sub-Saharan countries. METHODS: Electronic databases predominantly PubMed were searched. Databases, such as Google and Google scholar, were searched for gray literature. A funnel plot and Egger's regression test were used to see publication bias. Heterogeneity of the studies was checked by Forest plot and I-squared statistic. Both inverse-variance fixed-effect and DerSimonian and Laird random-effects methods were applied to estimate the pooled level of HRQoL (for both WHO-QoL-BREF and SF-36) and the effect size of associated factors. RESULT: From a total 776 retrieved studies, 16 studies were included for systematic review and meta-analysis. The pooled mean score of physical health, psychological, social relation and environmental health domain of WHO-QoL-BREF were 43.12, 47.40, 46.60 and 45.59 respectively. Age had a significant association (pooled ß = - 0.47), (pooled ß = - 0.24), (pooled ß = - 0.32) and (pooled ß = - 0.03) with physical health, psychological health, social relation and environmental health domains respectively. Being rural residence (pooled ß = - 0.32) was inversely associated with environmental health domain of WHO-QoL-BREF. Increased fasting blood sugar had a significant association (pooled ß = - 0.08, 95% CI - 0.11, - 0.05), (pooled ß = - 0.07) and (pooled ß = - 0.004) with physical health, psychological health and environmental health domains respectively. Having Co-morbidity (pooled ß = - 6.25) and diabetes related complication (pooled ß = - 5.65) were contrarily related to physical health domain of WHO-QoL-BREF. CONCLUSION: The pooled mean of physical and environmental domains of HRQOL scores was the least compared to the psychological and social domains. Being Old age and rural residence, increased fasting blood sugar, having co-morbidity and diabetic related complications were contrarily related to level of HRQoL. Therefore, we recommend that early detection and treatment of diabetes related complication and comorbidity and control of fasting blood sugar. While doing that due attention should be given for old and rural dwellers.
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Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/psicología , Calidad de Vida , África del Sur del Sahara , Comorbilidad , Femenino , Humanos , MasculinoRESUMEN
OBJECTIVES: Both diabetic peripheral neuropathy and depression have significant implications on patients' quality of life, management and outcomes. We aimed to evaluate all available evidence concerning patients with co-existent diabetic peripheral neuropathy and depression, and describe their clinical characteristics, in order to promote early recognition and management. METHODS: Systematic search of PubMed for studies providing data on patients with diabetic peripheral neuropathy and depression. The primary outcome was to evaluate all available evidence related to characteristics of diabetes, diabetic peripheral neuropathy and depression. Secondary study outcomes included comorbid conditions and complications in these patients. RESULTS: Final analysis included 24 studies with data on 205 patients. Most patients were adults between 18-65 years of age. Mean HbA1c value was above 8% and most patients were treated with insulin. Neuropathy was predominantly painful and most patients with available data were considered to have major depressive disorder. In addition to diabetic peripheral neuropathy and depression, diabetes-related complications were recorded in 43 patients, the most common being autonomic neuropathy, retinopathy and nephropathy. The most frequently reported comorbidities were weight loss (72 patients), impotence (60 patients), hypertension (23 patients) and coronary artery disease (22 patients). CONCLUSIONS: The present study describes the characteristics of patients with co-existent diabetic peripheral neuropathy and depression, aiming for prompt detection, prevention of further deterioration and improvement of patient outcomes. Available evidence shows that the majority of these patients are adults, with painful peripheral neuropathy and with insulin-treated and inadequately controlled diabetes.
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Depresión/epidemiología , Neuropatías Diabéticas/epidemiología , Adolescente , Adulto , Anciano , Comorbilidad , Depresión/complicaciones , Depresión/diagnóstico , Trastorno Depresivo Mayor/complicaciones , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/epidemiología , Complicaciones de la Diabetes/diagnóstico , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/psicología , Neuropatías Diabéticas/complicaciones , Neuropatías Diabéticas/diagnóstico , Neuropatías Diabéticas/psicología , Humanos , Persona de Mediana Edad , Factores de Riesgo , Adulto JovenRESUMEN
During the unprecedented times of the COVID 19 pandemic, the lives of people with diabetes have been severely impacted. This article discusses the extent of this impact presenting the obstacles and challenges from the perspective of the patient, including specifics of practical day-to-day diabetes self-management routines. Since the COVID19 outbreak, certain psychosocial factors have been amplifieddue tothe manner in whichmainstream media and policy makers have carelessly emphasized the vulnerability of people with diabetes. The authors discuss the increased importance of support networksdue to people living in isolation and quarantine. Anewlayer of complexity has been added to the already difficult task of managing one's diabetes and ithasincreasedanxiety and stress levels. Guidelines and tips for people living with diabetes are discussed based on theauthors' personalexperiences as well as those ofthe diabetes associations they work with.
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COVID-19/epidemiología , COVID-19/psicología , Diabetes Mellitus/psicología , Pandemias , Actividades Cotidianas/psicología , Ansiedad/epidemiología , Ansiedad/etiología , Ansiedad/terapia , COVID-19/prevención & control , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/prevención & control , Complicaciones de la Diabetes/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/terapia , Humanos , Percepción/fisiología , Sistemas de Apoyo Psicosocial , Calidad de Vida , Cuarentena , Conducta de Reducción del Riesgo , SARS-CoV-2/fisiología , Automanejo/métodos , Automanejo/psicología , Estrés Psicológico/epidemiología , Estrés Psicológico/etiología , Estrés Psicológico/terapiaRESUMEN
OBJECTIVES: The aim of the survey was to find out what the possible consequences are of the COVID-19 disease on the nervous system and to propose a method of using artificial intelligence. MATERIAL AND METHODS: Recent research has shown that the risks to patients due to severe acute coronavirus 2 respiratory syndrome (SARS-COV-2) differ most significantly depending on age and the presence of underlying comorbidities such as: cardiovascular disease, hypertension, diabetes and others. The consequences of COVID-19 on the nervous system are especially important. We performed a detailed selection of articles describing the effects of COVID-19 on the nervous system. RESULTS: We made a clear summary of the main consequences of COVID-19 on the nervous system and suggested a way to use artificial intelligence. CONCLUSION: We confirmed research that artificial intelligence methods have the potential to accelerate prediction, especially for the possible consequences of COVID-19 on the nervous system.
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COVID-19/complicaciones , Enfermedades del Sistema Nervioso/virología , Sistema Nervioso/virología , COVID-19/epidemiología , COVID-19/fisiopatología , COVID-19/psicología , Enfermedades Cardiovasculares/complicaciones , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/fisiopatología , Enfermedades Cardiovasculares/psicología , Comorbilidad , Complicaciones de la Diabetes/epidemiología , Complicaciones de la Diabetes/fisiopatología , Complicaciones de la Diabetes/psicología , Diabetes Mellitus/epidemiología , Diabetes Mellitus/fisiopatología , Diabetes Mellitus/psicología , Diabetes Mellitus/virología , Humanos , Hipertensión/complicaciones , Hipertensión/epidemiología , Hipertensión/fisiopatología , Hipertensión/psicología , Sistema Nervioso/fisiopatología , Enfermedades del Sistema Nervioso/epidemiología , Pandemias , SARS-CoV-2/fisiología , Encuestas y CuestionariosRESUMEN
PURPOSE: People with cystic fibrosis (CF) are predisposed to chronic conditions, such as CF-related diabetes (CFRD). Recent attention has been focused on the addition of screening for anxiety and depression in the CF population. Independently, CFRD and mental health conditions are associated with worse clinical outcomes; however, research assessing the impact of both conditions together is limited. We aimed to characterize the association between CFRD and selected diagnoses of anxiety or depressive disorders on clinical outcomes in adults with CF. METHODS: A single-center, retrospective, cross-sectional study in adult patients with CF was performed. Group comparisons included selected diagnoses of depression, anxiety, and CFRD using two-sample t-tests or rank-sum tests for continuous variables, and Chi-square or Fisher's exact tests for categorical variables. RESULTS: A total of 209 adults were enrolled (mean age of 31.4 ± 11.4 years). Those with a selected diagnoses of depression had a significantly higher proportion of CFRD than those without depression (48% vs. 28%, respectively, p = 0.005), and CFRD was associated with increased odds of depression [OR (CI) = 2.33 (1.28, 4.26), p = 0.006]. We did not see a higher proportion of adults with CFRD and selected diagnoses of anxiety than those without anxiety (41% vs. 31% respectively, p = 0.12), nor an increased odds of anxiety in those with CFRD [OR (CI) = 1.58 (0.88, 2.84), p = 0.12]. CONCLUSION: We show a significant association between CFRD and selected diagnoses of depression in a cohort of adult patients.
Asunto(s)
Trastornos de Ansiedad/epidemiología , Fibrosis Quística/complicaciones , Fibrosis Quística/psicología , Trastorno Depresivo/epidemiología , Complicaciones de la Diabetes/complicaciones , Complicaciones de la Diabetes/psicología , Adolescente , Adulto , Anciano , Trastornos de Ansiedad/diagnóstico , Estudios Transversales , Trastorno Depresivo/diagnóstico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
AIMS: This study evaluated the psychometric characteristics of the Polish version of the PHQ-9 in detecting major depression (MDD) and 'MDD and/or dysthymia' in people with and without type 2 diabetes. METHODS: Participants were randomly selected from a diabetes outpatient facility (N = 216) and from among patients admitted to a medical center and psychiatric hospital (N = 99). The participants completed the PHQ-9. The Hamilton Depression Rating Scale and the Mini International Neuropsychiatric Interview were used to identify the presence of psychiatric symptoms. The optimal cut-offs for PHQ-9 in people with and without type 2 diabetes were investigated based on two methods: 1) Youden's index which identifies cut-off points useful in scientific research; 2) a second method of two-stage screening for depressive disorders to provide guidance for clinical practice. RESULTS: The Polish version of the PHQ-9 is a reliable and valid screening tool for depression in people with and without type 2 diabetes. An optimal cut-off of ≥ 7 was indicated by Youden's index and ≥ 5 by the two-stage method for screening for MDD and 'MDD and/or dysthymia' in the group with type 2 diabetes. A cut-off of ≥ 11 was optimal for screening for both MDD and 'MDD and/or dysthymia' among people without diabetes (Youden's index). The two-stage approach suggested a ≥ 10 score for screening for MDD and ≥ 9 for screening for 'MDD and/or dysthymia' in people without diabetes. CONCLUSIONS: A lower cut-off score of the PHQ-9 is recommended for people with type 2 diabetes as compared to the general population.