Petrak F.,Ruhr University Bochum |
Rodriguez Rubio A.,Ruhr University Bochum |
Kaltheuner M.,Wissenschaftliches Institute der Niedergelassenen Diabetologen |
Scheper N.,Wissenschaftliches Institute der Niedergelassenen Diabetologen |
And 3 more authors.
Diabetes, Stoffwechsel und Herz | Year: 2011
Introduction: Representative data on the psychological burden of diabetes are lacking in Germany. Methods: This cross-sectional study was conducted across 18 specialized diabetes practices (SDPs ), involving 697 patients with diabetes (28.6% type 1). Questionnaires were used to assess diabetes-specific stress (PAID), psychological insulin resistance (BIT), diabetes-related self-care (SDSCA), and depressive and anxiety disorders (PHQ-D). Results: Diabetes-specific stress (PAID: 18.4 ± 15.6) and psychological insulin resistance (BIT sum score: 3.2 ± 1.4) were moderate. The prevalence of depression and anxiety disorders was 11.1 % and 4.4 %, respectively. A subgroup of patients (10.7 %, N = 73) experienced high diabetes specific distress (PAID ≥ 40) and showed specific characteristics compared to patients with low distress: Those patients were significantly younger (55.2 ± 15.0 vs. 59.8 ± 14.3 years of age, p < 0.05), more often affected by type 1 diabetes (41.7 % vs. 27.2 %, p < 0.05) and in poorer diabetes control (HbA1c: 7.8 ± 1.3 vs. 7.4 ± 1.2%, p < 0.05). Depression (43.8 % vs. 6.6 %, p < 0.001) and anxiety disorders (30.1 % vs. 3.9 %, p < 0.001) were much more common, and psychological insulin resistance was significantly higher in this specific subgroup (BIT sum score: 4.3 ± 1.5 vs. 3.1 ± 1.4, p < 0.001). Conclusion: Approximately 1 in 10 patients with type 1 diabetes treated in SDPs are affected by severe diabetes-specific stress.
Impact of the New Gestational Diabetes Guidelines of the German Diabetes Association on the Reality of Care: Data from a Large Register [Einfluss der Gestationsdiabetes-Leitlinie der DDG auf die Versorgungsrealität: Analysen des Register GestDiab]
Adamczewski H.,Wissenschaftliches Institute der niedergelassenen Diabetologen |
Weber D.,Wissenschaftliches Institute der niedergelassenen Diabetologen |
Faber-Heinemann G.,Wissenschaftliches Institute der niedergelassenen Diabetologen |
Heinemann L.,Wissenschaftliches Institute der niedergelassenen Diabetologen |
Kaltheuner M.,Wissenschaftliches Institute der niedergelassenen Diabetologen
Diabetologie und Stoffwechsel | Year: 2016
Background and aims: In 2011/2012a new guideline for gestational diabetes (GDM) and a revised version of the prenatal care guidelines were introduced in Germany. In order to identify the impact on the care of pregnant women with GDM, we analysed data systematically collected by specialized diabetes medical offices (DSP) in a large registry (GestDiab). Materials and methods:Data from 2334 pregnancies from 2009/2010 were compared with data from 4640 pregnancies in 2013/2014. Results: In 2013/14 GDM?was more frequently diagnosed between the 24th-28th week of gestation than in 2009/10: 33?% vs. 27?% (p?0.001). More pregnant women were treated with insulin: 40?% vs. 34?% (p?0.0001). The percentage of overweight and obese women was higher: 28?% vs. 26?% (p?0.001) and 35?% vs. 32?%, (p?0.001). Caesarean sections did not increase significantly (39?% vs. 38?% NS). More women participated in a postpartum diabetes screening 43?% vs. 39?% (p?0.001). In 2013/14 34?% of these had a pathological test. At this time 71?% of the mothers breast-fed their children. Conclusion: This analysis shows that implementation of the German GDM-guideline helped to improve quality of care: diagnosis and treatment of GDM?start earlier, allowing for more time for mother and children to benefit from therapy. The growing prevalence of adiposity among pregnant women emphasizes the need to focus on this additional health risk for mother and child. GDM?screening in combination with postpartum screening identifies families with severely elevated diabetes and cardiovascular risk. Copyright © 2016, Georg Thieme Verlag KG. All rights reserved.