Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI 48105, USA.
Diabetes Res Clin Pract. 2024 Mar;209:111596. doi: 10.1016/j.diabres.2024.111596. Epub 2024 Feb 28.
To evaluate relationships of hypoglycemia awareness, hypoglycemia beliefs, and continuous glucose monitoring (CGM) glycemic profiles with anxiety and depression symptoms in adults with type 1 diabetes (T1D) who use CGM.
A cross-sectional survey and data collections were completed with 196 T1D adults who used CGM (59% also used automated insulin delivery devices (AIDs)). We assessed hypoglycemia awareness (Gold instrument), hypoglycemia beliefs (Attitudes to Awareness of Hypoglycemia instrument), CGM glycemic profiles, demographics, and anxiety and depression symptoms (Hospital Anxiety and Depression Scale). Analysis included simple and multiple linear regression analyses.
Lower hypoglycemia awareness, weaker "hypoglycemia concerns minimized" beliefs, stronger "hyperglycemia avoidance prioritized" beliefs were independently associated with higher anxiety symptoms (P < 0.05), with similar trends in both subgroups using and not using AIDs. Lower hypoglycemia awareness were independently associated with greater depression symptoms (P < 0.05). In participants not using AIDs, more time in hypoglycemia was related to less anxiety and depression symptoms (P < 0.05). Being female and younger were independently associated with higher anxiety symptoms, while being younger was also independently associated with greater depression symptoms (P < 0.05).
Our findings revealed relationships of impaired hypoglycemia awareness, hypoglycemia beliefs, CGM-detected hypoglycemia with anxiety and depression symptoms in T1D adults who use CGMs.
评估低血糖意识、低血糖信念和连续血糖监测 (CGM) 血糖谱与使用 CGM 的 1 型糖尿病 (T1D) 成人的焦虑和抑郁症状之间的关系。
使用 CGM 的 196 名 T1D 成人(59%的人还使用了自动胰岛素输送设备 (AIDs))完成了横断面调查和数据收集。我们评估了低血糖意识(Gold 仪器)、低血糖信念(低血糖意识态度量表)、CGM 血糖谱、人口统计学特征以及焦虑和抑郁症状(医院焦虑和抑郁量表)。分析包括简单和多元线性回归分析。
低血糖意识较低、“低血糖担忧最小化”信念较弱、“避免高血糖优先”信念较强与焦虑症状较高独立相关(P<0.05),使用和不使用 AIDs 的亚组均存在类似趋势。低血糖意识较低与抑郁症状更严重独立相关(P<0.05)。在未使用 AIDs 的参与者中,更多时间处于低血糖状态与焦虑和抑郁症状减少相关(P<0.05)。女性和年轻与焦虑症状较高独立相关,而年轻也与抑郁症状更严重独立相关(P<0.05)。
我们的研究结果表明,在使用 CGM 的 T1D 成人中,受损的低血糖意识、低血糖信念、CGM 检测到的低血糖与焦虑和抑郁症状之间存在关系。