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首页> 外文期刊>Diabetes care >Depression and glycemic control in elderly ethnically diverse patients with diabetes: the IDEATel project.
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Depression and glycemic control in elderly ethnically diverse patients with diabetes: the IDEATel project.

机译：不同种族的老年糖尿病患者的抑郁和血糖控制：IDEATel项目。

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OBJECTIVE: The purpose of the study was to investigate the effect of comorbid depression on glycemic control and on response to a telemedicine case management intervention for elderly, ethnically diverse diabetic patients. RESEARCH DESIGN AND METHODS: Medicare beneficiaries in underserved areas were participants (n = 1,665) in the Informatics for Diabetes Education and Telemedicine (IDEATel) project and randomized to a telemedicine case management intervention or usual care. The data analyzed include baseline demographics (age, sex, race/ethnicity, marital status, insulin use, years of education, years of diabetes, and pack-years smoked) and measures of glycemic control (HbA(1c) [A1C]), comorbidity, diabetes symptom severity, functional disability and depression, and 1-year (n = 1,578) A1C. The association between depression and glycemic control was analyzed cross-sectionally and prospectively. RESULTS: At baseline, there was a significant correlation between depression and A1C and a trend for depression to predict A1C when other factors were controlled. However, in prospective analyses, depression did not predict change in A1C, either in the control or intervention group. CONCLUSIONS: In this large sample of elderly diabetic patients, a weak relationship between depression and A1C was found, but depression did not prospectively predict change in glycemic control. Thus, there is no evidence that depression should be used to exclude patients from interventions. Also, we should evaluate the impact of depression on outcomes other than glycemic control.
机译：目的：本研究旨在探讨合并抑郁症对老年糖尿病患者的血糖控制和远程医疗病例管理干预措施的反应。研究设计和方法：服务欠佳地区的Medicare受益人是糖尿病教育和远程医疗信息学（IDEATel）项目的参与者（n = 1,665），并被随机分配到远程医疗病例管理干预措施或常规护理中。分析的数据包括基线人口统计信息（年龄，性别，种族/民族，婚姻状况，胰岛素使用，受教育年限，糖尿病年份和吸烟年限）和血糖控制指标（HbA（1c）[A1C]），合并症，糖尿病症状严重，功能障碍和抑郁症以及1年（n = 1,578）A1C。横断面和前瞻性分析了抑郁症与血糖控制之间的关系。结果：在基线时，抑郁与A1C之间存在显着相关性，而在其他因素得到控制的情况下，抑郁趋势可预测A1C。但是，在前瞻性分析中，无论是对照组还是干预组，抑郁症均不能预测A1C的变化。结论：在大量的老年糖尿病患者样本中，发现抑郁症与A1C之间的关系较弱，但抑郁症并不能预测血糖控制的改变。因此，没有证据表明应使用抑郁症将患者排除在干预之外。另外，我们应该评估抑郁症对血糖控制以外的结果的影响。

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