JAMA:糖尿病-抑郁协同干预对共病患者临床症状的改善作用

2020-08-22 MedSci原创 MedSci原创

研究认为,对于糖尿病伴抑郁症患者,共病协同干预可显著改善患者24个月时抑郁症状和心血管代谢指标

统计发现,糖尿病患者中存在精神健康问题的比例日益增加,导致患者的预后恶化,并且多数患者的精神问题不能得到有效干预。近日研究人员考察了糖尿病-精神疾病共护理模式,对成年糖尿病伴抑郁症患者抑郁症状和心血管代谢指标的影响。   研究在印度开展,招募了2型糖尿病患者,患者健康问卷9评分至少为10分,血红蛋白A1c (HbA1c)至少为8%,收缩压(SBP)至少为140 mm Hg,或低密度脂蛋白(LDL)胆固醇至少为130 mg/dL。随机分为联合干预组(n=196)或对照组(n=208),联合患者接受了非医师护理协调员12个月的自我管理支持,电子健康记录决策支持以方便医生调整治疗和专家病例回顾,;随后在无干预的情况下再随访12个月。对照患者接受24个月以上的常规护理。研究的主要结果是24个月时组间抑郁症状量表(SCL-20)得分至少降低50%(范围为0-4;得分越高表示症状越严重),HbA1c降低至少0.5%,SBP降低5mmHg,LDL胆固醇降低10mg/dL的患者百分比差异。预先指定的次要终点是12个月和24个月时达到治疗目标(HbA1c<7.0%,SBP<130

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1910735, encodeId=9b7c1910e357b, content=<a href='/topic/show?id=0934229139c' target=_blank style='color:#2F92EE;'>#临床症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22913, encryptionId=0934229139c, topicName=临床症状)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Sun Aug 01 04:55:10 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813244, encodeId=136b813244ce, content=都是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61664774766, createdName=www.kangshiyizs, createdTime=Wed Aug 26 00:08:08 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=812494, encodeId=8d978124949c, content=不错 点赞收藏学习起来<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sun Aug 23 19:52:50 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036231, encodeId=06f4103623117, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043293, encodeId=b6dd1043293b1, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811991, encodeId=08d0811991cf, content=学习了,可以参考, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKM5opSMdO81JdZ2M7o9npdRIaB2cqAxzEC1Q9Hqht0VPJlxnQMx1IhAYibaFXYKg7emtfR6hkpZtA/132, createdBy=96432493356, createdName=yhthzx, createdTime=Sat Aug 22 09:59:17 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811972, encodeId=01848119e272, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>-<a href='/topic/show?id=0a0b5496306' target=_blank style='color:#2F92EE;'>#抑郁#</a><a href='/topic/show?id=fdda1038105a' target=_blank style='color:#2F92EE;'>#协同干预#</a>,这是新的思路,即真正以患者为中心,而不是以疾病为中心,通过协同干预,对两种疾病均有益。在临床上这种现象也经常看到高血压合并糖尿病的,使用二甲双胍后,血糖下来了,血压也会下来一样。但是,在实际过程中,涉及跨学科团队,很难真正实施起来。, beContent=null, objectType=article, channel=null, level=null, likeNumber=197, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=54963, encryptionId=0a0b5496306, topicName=抑郁), TopicDto(id=103810, encryptionId=fdda1038105a, topicName=协同干预)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 22 09:31:08 CST 2020, time=2020-08-22, status=1, ipAttribution=)]
    2020-08-26 www.kangshiyizs

    都是的

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1910735, encodeId=9b7c1910e357b, content=<a href='/topic/show?id=0934229139c' target=_blank style='color:#2F92EE;'>#临床症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22913, encryptionId=0934229139c, topicName=临床症状)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Sun Aug 01 04:55:10 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813244, encodeId=136b813244ce, content=都是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61664774766, createdName=www.kangshiyizs, createdTime=Wed Aug 26 00:08:08 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=812494, encodeId=8d978124949c, content=不错 点赞收藏学习起来<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sun Aug 23 19:52:50 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036231, encodeId=06f4103623117, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043293, encodeId=b6dd1043293b1, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811991, encodeId=08d0811991cf, content=学习了,可以参考, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKM5opSMdO81JdZ2M7o9npdRIaB2cqAxzEC1Q9Hqht0VPJlxnQMx1IhAYibaFXYKg7emtfR6hkpZtA/132, createdBy=96432493356, createdName=yhthzx, createdTime=Sat Aug 22 09:59:17 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811972, encodeId=01848119e272, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>-<a href='/topic/show?id=0a0b5496306' target=_blank style='color:#2F92EE;'>#抑郁#</a><a href='/topic/show?id=fdda1038105a' target=_blank style='color:#2F92EE;'>#协同干预#</a>,这是新的思路,即真正以患者为中心,而不是以疾病为中心,通过协同干预,对两种疾病均有益。在临床上这种现象也经常看到高血压合并糖尿病的,使用二甲双胍后,血糖下来了,血压也会下来一样。但是,在实际过程中,涉及跨学科团队,很难真正实施起来。, beContent=null, objectType=article, channel=null, level=null, likeNumber=197, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=54963, encryptionId=0a0b5496306, topicName=抑郁), TopicDto(id=103810, encryptionId=fdda1038105a, topicName=协同干预)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 22 09:31:08 CST 2020, time=2020-08-22, status=1, ipAttribution=)]
    2020-08-23 仁心济世

    不错 点赞收藏学习起来#学习#

    0

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    2020-08-22 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1910735, encodeId=9b7c1910e357b, content=<a href='/topic/show?id=0934229139c' target=_blank style='color:#2F92EE;'>#临床症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22913, encryptionId=0934229139c, topicName=临床症状)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Sun Aug 01 04:55:10 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813244, encodeId=136b813244ce, content=都是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61664774766, createdName=www.kangshiyizs, createdTime=Wed Aug 26 00:08:08 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=812494, encodeId=8d978124949c, content=不错 点赞收藏学习起来<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sun Aug 23 19:52:50 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036231, encodeId=06f4103623117, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043293, encodeId=b6dd1043293b1, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811991, encodeId=08d0811991cf, content=学习了,可以参考, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKM5opSMdO81JdZ2M7o9npdRIaB2cqAxzEC1Q9Hqht0VPJlxnQMx1IhAYibaFXYKg7emtfR6hkpZtA/132, createdBy=96432493356, createdName=yhthzx, createdTime=Sat Aug 22 09:59:17 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811972, encodeId=01848119e272, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>-<a href='/topic/show?id=0a0b5496306' target=_blank style='color:#2F92EE;'>#抑郁#</a><a href='/topic/show?id=fdda1038105a' target=_blank style='color:#2F92EE;'>#协同干预#</a>,这是新的思路,即真正以患者为中心,而不是以疾病为中心,通过协同干预,对两种疾病均有益。在临床上这种现象也经常看到高血压合并糖尿病的,使用二甲双胍后,血糖下来了,血压也会下来一样。但是,在实际过程中,涉及跨学科团队,很难真正实施起来。, beContent=null, objectType=article, channel=null, level=null, likeNumber=197, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=54963, encryptionId=0a0b5496306, topicName=抑郁), TopicDto(id=103810, encryptionId=fdda1038105a, topicName=协同干预)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 22 09:31:08 CST 2020, time=2020-08-22, status=1, ipAttribution=)]
    2020-08-22 misszhang

    谢谢MedSci提供最新的资讯

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1910735, encodeId=9b7c1910e357b, content=<a href='/topic/show?id=0934229139c' target=_blank style='color:#2F92EE;'>#临床症状#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22913, encryptionId=0934229139c, topicName=临床症状)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3860283, createdName=whmdzju, createdTime=Sun Aug 01 04:55:10 CST 2021, time=2021-08-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=813244, encodeId=136b813244ce, content=都是的, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=61664774766, createdName=www.kangshiyizs, createdTime=Wed Aug 26 00:08:08 CST 2020, time=2020-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=812494, encodeId=8d978124949c, content=不错 点赞收藏学习起来<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=仁心济世, createdTime=Sun Aug 23 19:52:50 CST 2020, time=2020-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036231, encodeId=06f4103623117, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1043293, encodeId=b6dd1043293b1, content=谢谢MedSci提供最新的资讯, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=misszhang, createdTime=Sat Aug 22 11:55:10 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811991, encodeId=08d0811991cf, content=学习了,可以参考, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKM5opSMdO81JdZ2M7o9npdRIaB2cqAxzEC1Q9Hqht0VPJlxnQMx1IhAYibaFXYKg7emtfR6hkpZtA/132, createdBy=96432493356, createdName=yhthzx, createdTime=Sat Aug 22 09:59:17 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=811972, encodeId=01848119e272, content=<a href='/topic/show?id=4f77e665253' target=_blank style='color:#2F92EE;'>#糖尿病#</a>-<a href='/topic/show?id=0a0b5496306' target=_blank style='color:#2F92EE;'>#抑郁#</a><a href='/topic/show?id=fdda1038105a' target=_blank style='color:#2F92EE;'>#协同干预#</a>,这是新的思路,即真正以患者为中心,而不是以疾病为中心,通过协同干预,对两种疾病均有益。在临床上这种现象也经常看到高血压合并糖尿病的,使用二甲双胍后,血糖下来了,血压也会下来一样。但是,在实际过程中,涉及跨学科团队,很难真正实施起来。, beContent=null, objectType=article, channel=null, level=null, likeNumber=197, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76652, encryptionId=4f77e665253, topicName=糖尿病), TopicDto(id=54963, encryptionId=0a0b5496306, topicName=抑郁), TopicDto(id=103810, encryptionId=fdda1038105a, topicName=协同干预)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=lovetcm, createdTime=Sat Aug 22 09:31:08 CST 2020, time=2020-08-22, status=1, ipAttribution=)]
    2020-08-22 yhthzx

    学习了,可以参考

    0

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    2020-08-22 lovetcm

    #糖尿病#-#抑郁##协同干预#,这是新的思路,即真正以患者为中心,而不是以疾病为中心,通过协同干预,对两种疾病均有益。在临床上这种现象也经常看到高血压合并糖尿病的,使用二甲双胍后,血糖下来了,血压也会下来一样。但是,在实际过程中,涉及跨学科团队,很难真正实施起来。

    0

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Am J Resp Crit Care:睡眠呼吸障碍和失眠与高血压和糖尿病的关联

SDB与高血压和糖尿病有关。失眠与高血压有关。这些结果支持将睡眠障碍作为预防和减少疾病的可改变靶标的重要性。

高脂牛奶大胆喝!乳制品(≥3份/天)对糖尿病患者的血糖、体重无影响

糖尿病,部分是由于饮食习惯不健康导致的。例如,暴饮暴食、大鱼大肉以及偏少的五谷杂粮等等。如果按照这种理论,那么有人会反问:乳制品属于营养品,而且还是高脂的乳制品,真的可以随便喝吗?