Effects Of Health Education On Blood Glucose And Depressive Symptoms In Patients With Type 2 Diabetes Mellitus

Objective:Type 2 diabetes mellitus(T2DM)and depression are serious social and public health problems.With the development of diabetes,the appearance of depressive symptoms brings poor prognosis for patients,such as serious complications,decreased quality of life,and increased mortality.With the increase of morbidity year by year,their comorbidity not only increases the suffering of patients,but also increases the social medical burden.This study aims to investigate the clinical characteristics and influencing factors of depressive symptoms in patients with T2 DM,and observe the improvement of blood glucose and depressive symptoms in patients with T2 DM after health education.To provide reference for the comprehensive treatment of diabetes patients.Methods:A total of 153 patients diagnosed with T2 DM admitted to the First Hospital of Shanxi Medical University from December 2021 to August 2022 were collected.They were divided into depressive symptom group and non-depressive symptom group by self-rating Depression Scale(SDS).The quality of life of patients with diabetes was assessed by DSQL.General data and metabolic indicators(blood glucose,blood lipid,thyroid function)were collected,univariate analysis and multivariate logistic regression analysis were performed to analyze the influencing factors of depressive symptoms in T2 DM patients.T2 DM patients with depressive symptoms were given health education and followed up for3 months,and then the improvement of blood glucose and depressive symptoms was observed again.Results:A total of 153 diabetic patients were included in this study,and 48 patients with depressive symptoms were screened out by SDS,with a positive rate of 32.4%.Univariate analysis showed that compared with the non-depressive group,the depressive group had more females,older age,longer diabetes course,and significantly increased the incidence of diabetic nephropathy(DN)and diabetic peripheral neuropathy(DPN).Fasting blood glucose(FBG),postprandial blood glucose(PBG),glycosylated hemoglobin(Hb A1c)and DSQL scores were significantly increased(P < 0.05),while free triiodothyroxine(FT3)was decreased(P < 0.05).There were no significant differences in family history of diabetes,insulin therapy,diabetic retinopathy(DR),diabetic peripheral vascular disease(DPA),hypertension,cardiovascular disease,ischemic brain disease,heart rate and diastolic blood pressure between the two groups(P > 0.05).Multivariate logisitic regression analysis showed that Hb A1c(OR= 2.285,95%CI(1.426,3.660),P=0.001),DSQL(OR=1.179,95%CI(1.094,1.271),P < 0.001),FT3(OR=0.356,95%CI(0.137,0.923),P=0.034)was associated with the occurrence of depressive symptoms.Hb A1 c,DSQL and lower FT3 levels were the influencing factors of depressive symptoms in T2 DM.After health education follow-up,FPG,PPG and SDS scores of T2 DM patients with depressive symptoms were significantly decreased(P < 0.05).Conclusion:Depressive symptoms were common in T2 DM patients,and the SDS screening rate was 32.4%.T2 DM combined with depressive symptoms impaired blood glucose control and worsened quality of life.Hb A1 c,DSQL and FT3 were correlated with depressive symptoms in T2 DM patients.Health education can effectively improve blood glucose management and the occurrence of depressive symptoms in patients with T2 DM,suggesting that early psychological care is crucial for patients with diabetes,especially those with a long course of diabetes.