Impact of anxiety, depression and disease-related distress on long-term
glycaemic variability among subjects with Type 1 diabetes mellitus
Abstract
Aims: Anxiety, depression, and disease-related distress are linked to
worse overall glycaemic control, in terms of HbA1c. This study was aimed
to evaluate whether these emotional disorders are associated with
long-term glycaemic variability in subjects with Type 1 diabetes.
Methods: Longitudinal retrospective study. Six-year HbA1c data
(2014-2019) from 411 subjects with Type 1 diabetes who had participated
in a previous study to design a diabetes-specific quality of life
questionnaire in the year 2014 were included. Scores for Spanish
versions of the Hospital Anxiety and Depression Scale (HADS) and Problem
Areas in Diabetes (PAID) scale were obtained at baseline, along with
sociodemographic and clinical data. Long-term glycaemic variability was
measured as the coefficient of variation of HbA1c (HbA1c-CV). The
association between HADS and PAID scores and HbA1c-CV was analysed with
Spearman correlations and multiple regression models, both linear and
additive, including other covariates (age, sex, diabetes duration time,
type of treatment, use of anxiolytic or antidepressant drugs, education
level and employment status). Results: Scores of depression, anxiety and
distress were positively and significantly correlated to HbA1c-CV in
univariate analyses. Multiple regression study demonstrated an
independent association only for diabetes distress and anxiety scores
(p= 0.010 and p=0.015, respectively). Age, diabetes duration time,
education level and employment status were also significantly associated
with HbA1c-CV. Conclusion: There is a relationship between psychological
factors and long-term glycaemic variability in subjects with Type 1
diabetes.