A Case-control Study On The Risk Factors Of Brittle Diabetes

Objective By evaluating brittle diabetes patients and diabetes patients’general information, psychological and mental state, the overall status of self management, in order to analyse and explore the specific factors of brittle diabetes, and provide a clue for brittle diabetes management and health education.Methods A case-control study without matching design was used in this study. Patients were enrolled from January 2015 to December 2015 in Endocrinology Department of Affiliated hospital of Nanjing University of Chinese Medicine and Jiangsu Province Hospital of integrated Traditional Chinese and Western medicine.30 patients with brittle diabetes diagnosis standards as the case group, and select the same period in line with the diagnostic criteria of 73 diabetes patients as control group.Using general situation questionnaire to collect the patient’s social and demographic data, disease status, measuring project and related laboratory indexes, use SCL-90 to investigate the patient’s psychological and mental state, and use SDSCA to assess the patient’s level of self management.The data of this study were analyzed by SPSS 20.0, using the frequency, mean and standard deviation for statistical description;Measurement data first to do tests of normality and test of homogeneity of variance, accord with normal distribution and egual variances we use Independent-Samples T test,if not,we use Mann-Whitney tset.Count data using the chi-square test, hierarchical data using Wilcoxon rank of nonparametric test and inspection for statistical inference.For analyzing the influential factors of brittle diabetes adopt unconditioned Logistic regression screening of brittle diabetes risk and protective factors, calculated odds ratio (OR) and 95%confidence interval (95%CI), included in the standard 0.05, excluding standard is 0.10.Results1. In 103 patients,58 male patients and 45 female patients; By comparison, the sex of the two groups has no statistical difference (P> 0.05). The case group’s average age was (50.75 ± 16.32);The control group’s average age was (59.25±13.53);The age of the two groups are statistically significant (P< 0.05). Two groups of smoking situation and marital status were statistically significant (P< 0.05), but living status, educational level, family monthly income, employment, drinking aspects were no statistical difference (P> 0.05).2. Two groups of BMI and waist circumference results were statistically significant (P< 0.05).But the length of the course of the diabetes, whether there is family history of diabetes, the number of complications and the presence of complications had no statistical difference(P> 0.05).3. The basis C peptide and 120 minute C peptide levels of the case group are lower than the control group, compared two groups of C peptide level was statistically difference (P< 0.05). in addition, compared two groups of IAA, urine ketone body, urine glucose,24 hours urinary protein,TT3 and FT3 were statistically significant (P< 0.05).4. Both groups of total scores, total average scores, positive numbers, in forcing symptoms,interpersonal sensitivity, depression, anxiety, hostility, paranoia, psychosis and other aspects of the results were statistically significant (P< 0.05).5. Compared two groups of the Summary of diabetes self-care activities questionnaire scores, only prescribed medication aspect had statistically difference (P< 0.05).6. Single factor analysis screened out age,marital status,smoking,waist circumference, BMI, C peptide, HbAlc, IAA, SCL-90 total score, forcing symptoms, interpersonal sensitivity, depression, anxiety, hostility, paranoia, psychosis,other aspects and prescribed medication, these factors as independent variables, whether be attacked by brittle diabetes as the dependent variable, to multiariable Logistic regression analysis, the results showed no statistical difference.Conclusion1. The brittle diabetes are more likely to happen in the younger, smoking, divorced or widowed, thin type of patients, with a low C peptide, more urine ketone body and urine glucose excretion features.2. There is no essential difference in disease risk factors between the brittle diabetes patients and diabetes patients. The management measures of diabetes can also be applied to brittle diabetes.3. The results of SCL-90 show that brittle diabetes patients suffered more psychological pressure than those patients without brittle diabetes, and we should strengthen the psychological intervention of brittle diabetes, especially sensitive interpersonal relationship, depression, anxiety, hostility, etc.