Investigation On Anxiety And Depression In Patients With Type 2 Diabetes

Type 2 diabetes mellitus is a common chronic and metabolic disease.With the acceleration of life rhythm,changes in lifestyle,increasing social pressure and population aging,T2 DM has become a rapidly growing global social public problem.T2 DM is an incurable,chronic and lifelong disease,which often brings physical and mental pain to patients.It also has a significant impact on the quality of life of people in all parts of the world,especially for developing countries,China has become the largest diabetes country in the world.Due to the long-term nature of the disease and the diversity of complications,it is easy to cause organ dysfunction or even failure,which increases the mortality of patients.This will undoubtedly bring heavy economic burden to society and families,and at the same time,it is easy to accompany various psychological disorders,and bad psychology can also accelerate the emergence of disease.Many studies have found that patients with T2 DM are often accompanied by psychological disorders,the most common is anxiety and/or depression,and anxiety and depression and other emotions can affect the development and outcome of T2 DM.Scholars at home and abroad have different reports on the incidence of depression in patients with T2 DM,and there are few studies on anxiety.Therefore,this study is devoted to understanding the prevalence of anxiety and depression in patients with T2 DM in our region,exploring the influencing factors of anxiety and depression in patients with T2 DM,paying attention to the psychological status of patients with T2 DM,and giving more care and support to patients with T2 DM.Objective:This study evaluates the incidence of anxiety and depression in patients with T2 DM through questionnaires,analyses and discusses the related influencing factors of anxiety and depression,and provides theoretical reference for the mental health status and blood sugar management of patients with T2 DM.Methods:A cross-sectional survey was conducted to collect 261 patients with T2 DM who were admitted to the Department of Endocrinology,the First Affiliated Hospital of Henan University from September2017 to December 2018.The patient's psychological status questionnaire(PHQ9 depression assessmentform,GAD7 anxiety assessment form)was used.The patients were tested for anxiety and depression.According to the evaluation results,the patients were divided into T2 DM group(control group)and T2 DM with anxiety and depression group(experimental group).The general status information of the patients was collected by asking the medical history(name,gender,age,body mass index,duration of diabetes,education,monthly income,marital status,complications and complications of diabetes,history of smoking,family history of diabetes,pre-hospital medication).Record laboratory parameters including fasting C-peptide,fasting blood glucose,2 hours postprandial blood glucose,glycosylated hemoglobin,cortisol level,blood lipids,etc..All data were statistically analyzed using SPSS 22.0 statistical software.The basic situation of the study object was described by statistical methods,and the measurement data were expressed by mean ± standard deviation.The two groups of data for homogeneity of variance were compared using t test,and vice versa.The chi-square test was used to compare the count data.P < 0.05 indicates statistical significance.The incidence of anxiety and depression in the study population was calculated,and the related factors of anxiety and depression in patients with type 2 diabetes were discussed.Results:1.Among 261 hospitalized patients with type 2 diabetes,143 were anxiety-depressed,the incidence of anxiety and depression was 54.79%,including 79 males and 64 females.The anxiety score of the T2 DM group was 2.31±1.56,the depression score was 2.64±2.67,the anxiety score of T2 DM with anxiety and depression group was 7.48±4.08,and the depression score was 9.11±4.96.2.There were significant differences in duration of diabetes mellitus,economic status,marital status,number of complications of diabetes mellitus,number of oral drugs,use of insulin and number of insulin injections between simple T2 DM and T2 DM with anxiety and depression(P < 0.05).Age,fasting blood sugar,glycosylated hemoglobin,cortisol at 8 a.m.,cortisol at 4 p.m.and cortisol at 0 a.m.in patients with anxiety and depression were higher than those without anxiety and depression(P < 0.05).There were no significant differences in gender,BMI,education level,smoking,diabetes complications,family history of diabetes mellitus,fasting C-peptide level,2-hour postprandial blood sugar and blood lipid between the two groups(P > 0.05).3.Logistic regression analysis found that type 2 diabetes mellitus with anxiety and depression were positively correlated with the course of diabetes,the number of complications of diabetes,blood sugarcontrol level and blood alcohol level,which were risk factors,negatively correlated with economic status,number of oral drugs,which were protective factors.Conclusion:1.The incidence of anxiety and depression is high in hospitalized patients with type 2 diabetes mellitus,and the psychological status of type 2 diabetes mellitus was poor;2.Long duration of diabetes,high number of diabetic complications,poor glycemic control,and blood alcohol arrhythmia lead to anxiety and depression in T2 DM patients,and good economic status,less number of oral drugs can reduce the risk of anxiety and depression in T2 DM patients;3.Serum cortisol levels increased in patients with T2 DM associated with anxiety and depression,Hypothalamic-pituitary-adrenal axis may be one of the neuroendocrine mechanisms of anxiety and depression.