早发2型糖尿病初期患者合并焦虑或抑郁的临床观察

目的 观察早发2型糖尿病患者经规范、合理的治疗前后焦虑或抑郁的变化情况.方法 2008年5月～2012年4月共纳入76例早发2型糖尿病初诊患者,给予磺脲类或预混胰岛素为主的降糖治疗和糖尿病知识健康宣教；分别于确诊时、治疗1个月和治疗3个月用焦虑自评量表(SAS)和抑郁自评量表(SDS)进行评价,并于确诊时和治疗3个月检测糖化血红蛋白(HbA1c)的变化情况.结果 76例患者血糖控制均获满意,平均治疗控制时间为(20.5±8.1)d.确诊时76例患者中分别有46例(60.5％)和33例(43.4％)伴有不同程度的焦虑和抑郁,SAS和SDS量表评分分别为54.2±15.1和49.7±14.3；治疗1个月有2例失访出组,74例患者中分别有31例(41.9％)和20例(27.0％)伴有不同程度的焦虑和抑郁,SAS和SDS评分分别为45.9±11.1和41.6±10.7,与确诊时比较差异均有统计学意义(P＜0.05)；治疗3个月对70例患者(4例失访)再次进行SAS和SDS量表评分,仅有11例(15.7％)和8例(11.4％)伴有不同程度的焦虑或抑郁,评分分别为32.8± 11.2和31.2±11.4,与确诊时和治疗1个月比较差异均有统计学意义(P＜0.05).70例患者确诊时和治疗3个月HbA1c分别为(9.8±2.4)％和(5.0±1.1)％,差异有统计学意义(P＜0.05).结论 早发2型糖尿病患者的焦虑和抑郁情况较为普遍且严重,规范、合理的降糖治疗和糖尿病知识健康宣教不仅能够有效控制血糖,还可以改善患者的焦虑和抑郁,值得基层医院和专科门诊借鉴.

Observation of the early onset of type 2 diabetes mellitus patients complicated with anxiety or depression

Objective To observe the change of anxiety or depression in the early onset type 2 diabetes mellitus patients before and after standard,reasonable treatment.Methods From May 2008 to April 2012,76 newly diagnosed early onset type 2 diabetes mellitus patients were enrolled,sulfonylurea or premixed insulin hypoglycemic therapy and diabetes knowledge of health education were given.The changes of glycosylated hemoglobin（HbA1c） levels were evaluated with Self-rating Anxiety Scale（SAS） and the Self-rating Depression Scale（SDS） during diagnosis,one and three months after treatment.Results The blood glucose level in 76 patients were well controlled within（20.5± 8.1） d.Anxiety and depression of varied degrees were observed in 46 cases（60.5%） and 33 cases（43.4%） with the SAS and SDS scores of 54.2± 15.1 and 49.7± 14.3.There were 31 cases（41.9%） and 20 cases（27%） with different degrees of anxiety and depressionv with SAS and SDS scores of 45.9± 11.1 and 41.6± 10.7,showing significant differences compared to those at time of daignosis（P 0.05）.After treatment for 3 months,out of the 70 cases follwed-up only 11 cases（15.7%） and 8 cases（11.4%） with different degrees of anxiety or depression with SAS and SDS scores of 32.8± 11.2 and 31.2± 11.4 respectively,showing significant differences compared to those at the time of diagnosis and a month after treatment（P 0.05）.The HbA1c levels in those at the time of diagnosis and three months after treatment were（9.8 ± 2.4） % and（5 ± 1.1） % respectively,showing statistically significant differences（P 0.05）.Conclusion Early onset type 2 diabetes mellitus patients complicated with anxiety and depression is common and serious.Standard and reasonable antidiabetic treatment and offering dianbetic knowledge can not only effectively control blood glucose,but also reduce the degree of anxiety and depression.