Abstract
Objectives
To examine the association of depressive symptoms (DS) and diabetes-related distress
(DD) with severe hypoglycemia (SH) in adults with type 2 diabetes.
Methods
Baseline data from a cohort study of adults with type 2 diabetes (N=2,040) were used.
The Patient Health Questionnaire 8-items and Problem Areas in Diabetes 5-items questionnaires
were used to assess DS and DD, respectively. SH was defined as a positive report of
“calling an ambulance or visiting an emergency department because of hypoglycemia
in the past year.” Composite dummy variables for the 2 stratification levels of DS
and DD were computed and used in multivariable logistic regression analyses.
Results
Participants had a mean (± SD) age of 64±11 years, and 45% were female. The average
duration of diabetes was 12±9 years; 3% had moderate to severe DS, 8% had moderate
to severe DD and 5% had moderate to severe levels of both symptoms. Only 4.2% of participants
reported experiencing SH in the past year. The presence of any level of DD (adjusted
OR 2.3; 95% CI 1.3, 3.9) or moderate to severe DD (2.2; 1.1, 4.2) was associated with
increased risk for SH. Combinations of any levels of DD and DS (4.3; 2.5, 7.3) and
moderate to severe DD and DS (2.3; 1.1, 4.8) were associated with increased risk for
SH. The presence of any level of DS alone (1.2; 0.3, 4.9) or moderate to severe DS
(1.7; 0.6, 5.1) was not associated with increased risk for SH.
Conclusions
Patients with type 2 diabetes and symptoms of depression, but not diabetes-related
distress alone, were more likely to experience SH than those without either of these
symptoms.
Résumé
Objectifs
Examiner l'association des symptômes de dépression (SD) et de la détresse liée au
diabète (DD) à l'hypoglycémie grave (HG) chez les adultes atteints du diabète de type
2.
Méthodes
Nous avons utilisé les données initiales d'une étude de cohorte d'adultes atteints
du diabète de type 2 (N = 2040). Nous avons utilisé les questionnaires respectifs
PHQ-8 (Patient Health Questionnaire 8-items) et PAID-5 (Problem Areas in Diabetes 5-items) pour évaluer les SD et la DD. La HG a été définie ainsi lorsqu'elle a nécessité
l'« appel d'une ambulance ou une visite au service des urgences en raison d'une hypoglycémie
au cours de la dernière année ». Nous avons calculé et utilisé les variables factices
composites de 2 niveaux de stratification des SD et de la DD dans les analyses multivariées
de régression logistique.
Résultats
Quarante-cinq pour cent (45 %) des participants, dont l'âge moyen était de 64 ± 11
ans, étaient des femmes. La durée moyenne du diabète était de 12 ± 9 ans, 3 % avaient
des SD modérés à graves, 8 % avaient de la DD modérée à grave et 5 % avaient des niveaux
modérés à graves des 2 symptômes. Seuls 4,2 % des participants rapportaient avoir
subi une HG au cours de la dernière année. La présence de tout niveau de DD (RIR ajusté
2,3; IC à 95 % 1,3, 3,9) ou de DD modérée à grave (2,2; 1,1, 4,2) était associée à
une augmentation du risque de HG. Les combinaisons de tous les niveaux de DD et de
SD (4,3; 2,5, 7,3) et de DD et de SD modérés à graves (2,3; 1,1, 4,8) étaient associées
à une augmentation du risque de HG. La présence de tout niveau de SD seuls (1,2; 0,3,
4,9) ou de SD modérés à graves (1,7; 0,6, 5,1) n'était pas associée à une augmentation
du risque de HG.
Conclusions
Les patients atteints du diabète de type 2 et de symptômes de dépression, mais non
seulement de détresse liée au diabète, étaient plus susceptibles de subir une HG que
ceux qui n'avaient aucun de ces symptômes.
Keywords
Mots clés
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Article Info
Publication History
Published online: November 14, 2018
Accepted:
November 8,
2018
Received in revised form:
May 16,
2018
Received:
August 8,
2017
Footnotes
The Canadian Diabetes Association is the registered owner of the name Diabetes Canada.
Identification
Copyright
© 2018 Canadian Diabetes Association
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- Clinical Considerations in Adult Patients With Comorbid Type 2 Diabetes and Depressive Symptoms Associated With Severe HypoglycemiaCanadian Journal of DiabetesVol. 44Issue 4
- PreviewWe read the article written by Al Sayah et al, “Association of depressive symptoms and diabetes distress with severe hypoglycemia in adults with type 2 diabetes” (1). The authors concluded that the presence of any level of diabetes distress (DD) alone, or DD and depressive symptoms (DSs) combined, “was associated with an increased risk for experiencing severe hypoglycemia (SH)” (1). However, DSs alone are not associated with increased risk of SH. As such, the study claims that although DD and DSs have overlapping features, each plays a unique role in contributing to hypoglycemic episodes in type 2 diabetes.
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