Phobic symptoms and anxiety-depression were positively associated with GHb levels, explaining 41% of the variance in GHb alongside the frequency of daily blood glucose measurements.
Cross-Sectional (n=102)
Observer-blind
Are phobic symptoms, particularly fear of blood and injury, associated with poor glycemic control in adults with Type I diabetes?
Phobic symptoms, especially fear of blood and injury, negatively impact metabolic control in Type I diabetes by reducing the frequency of home blood glucose monitoring.
OBJECTIVE: To investigate the presence of psychiatric disorders and symptoms in type I diabetic patients and to identify those that may influence metabolic control as assessed by GHb levels. RESEARCH DESIGN AND METHODS: This was a cross-sectional study. One hundred and two consecutive patients with type I diabetes who were regular outpatient visitors of a diabetology department were evaluated. The psychiatric assessments included self-rating questionnaires (General Health Questionnaire and Fear Questionnaire) and observer-rating questionnaires (Montgomery-Asberg Depression Rating Scale MADRS and Mini International Interview). Diabetic characteristics were assessed by a structured interview. The observer was blind to the diabetic characteristics of the patients. RESULTS: Type I diabetic patients with GHb levels > or = 8% had higher psychological distress, scored significantly higher for symptoms of agoraphobia and for fear of blood and injury, had substantially higher levels of anxiety-depression, and performed significantly fewer blood glucose measurements per day. They did not differ in MADRS score from patients with GHb levels < 8%. Multivariate analysis showed that GHb was positively associated with the total score of phobic symptoms and the level of anxiety-depression and inversely associated with the number of daily blood glucose measurements. These factors explained 41% of the variance of GHb. The inverse relationship between GHb and the number of blood glucose measurements per day was mainly influenced by the fear of blood and injury. Patients with high scores for the fear of blood and injury performed fewer blood glucose measurements and had poorer glycemic control; conversely, subjects without fear of blood and injury performed more daily blood glucose measurements and had better glycemic control. CONCLUSIONS: Phobic symptoms are frequent in patients with type I diabetes. The intensity of phobic symptoms and anxiety-depression negatively influences metabolic control. Increased fear of blood and injury may lead some patients to perform few home blood glucose measurements and may result in poorer glycemic control. This suggests that, by decreasing the fear of blood, injury, and injection, metabolic control may be improved.
Berlin et al. (Sat,) conducted a cross-sectional in Type I diabetes (n=102). Phobic symptoms and anxiety-depression vs. Lower levels or absence of phobic symptoms and anxiety-depression was evaluated on Metabolic control assessed by GHb levels. Phobic symptoms and anxiety-depression were positively associated with GHb levels, explaining 41% of the variance in GHb alongside the frequency of daily blood glucose measurements.