Endocrine Abstracts

Background

It has often been argued that important psychosocial factors such as depression, anxiety and emotional stress can influence self-help behavior and therefore negatively affect glycemic control. In turn, the reduced quality of life due to chronic illness is a mediated cause of poor glycemic control. Also, attention is drawn to the prevalence of cognitive impairments and dementia.

Aims

1) to assess the psychological status of patients with diabetes; 2) to describe subgroups of patients with anxious and depressive reactions; 3) to assess quality of life. To assess the current status of diabetic self-management behavior and the factors responsible for such knowledge among type 2 diabetes patients in Minsk, Belarus.

Methods

Questionnaires were used to assess cognitive impairment (MoCA), depressive disorders (PHQ-9), anxiety disorders (GAD-7), quality of life (RU-ADDQol).

Results

We examined a total of 206 patients in the present study. The prevalence of cognitive decline was 79.07±3.10% (136/172) (25 and below points) in patients with type 2 diabetes. The average score was 19.00 (18.00; 25.00). The average value of depressive reactions on the PHQ-9 scale in the study group was 11.00 (8.00; 13.00). Mean of anxious reactions on the GAD-7 scale in the study group was 8.50 (5.75; 11.00). The average value of the quality of life on the RU-ADDQol scale in the study group was –3.21 (–3.68; –2.84); the average value for men is –2.63 (–3.12; –2.42), for women –3.39 (–3.74; –3.04). The differences are statistically significant between men and women (W-statistic: 4144.50, p-value: <0.001). The lowest score was obtained for the parameter motivation (–4.11), freedom to eat (–4.48), financial situation (–4.18), feelings about future (–3.87). We also analyzed the correlation of the level of glycated hemoglobin with the level of cognitive decline, depressive and anxiety reactions, and the level of quality of life.

Discussion

The prevalence of cognitive impairments, anxiety and depressive reactions in the population of patients with type 2 diabetes mellitus is higher than among a similar sample of healthy people. Psychological factors (cognitive impairment, anxiety and depressive reactions) negatively affect metabolic parameters, motivation and limit the ability to adapt to type 2 diabetes. In addition, mental factors were directly correlated with poor glycated hemoglobin levels and quality of life.

Keywords: behavior, RU-ADDQol, diabetes/quality of life, depression, anxiety, psychology, type 2 diabetes mellitus, eastern europe.