Sleep quality in relation to perceived psychological stress in patients with type 2 diabetes and in age- and sex-matched control individuals.

AIM: To assess sleep quality in relation to perceived stress in patients with type 2 diabetes (T2DM) and age- and sex-matched controls. METHODS: Perceived stress level and sleep quality assessed in 154 patients with T2DM (58 men, 96 women, age 58.3 ± 11.9 years), 154 matched controls (58 men, 96 women, age 56.8 ± 12.2 years) using Perceived Stress Scale and Pittsburgh Sleep Quality Index. RESULTS: Patients with T2DM had worse subjective sleep quality (p < 0.001), sleep latency (p = 0.047) than controls. Patients with high stress level had worse subjective sleep quality (p = 0.027), higher use of sleeping medication (p = 0.023), daytime dysfunction (p < 0.001) than those with low stress level. No significant differences in sleep quality between controls with high and low perceived stress level. Perceived stress level in patients with T2DM correlated with subjective sleep quality (r = 0.260, p = 0.002), sleep duration (r = 0.228, p = 0.005), use of sleep medication (r = 0.245, p = 0.004), daytime dysfunction (r = 0.326, p < 0.001), in age- and sex-matched controls-to daytime dysfunction (r = 0.191, p = 0.037). CONCLUSION: Sleep quality (subjective sleep quality, sleep latency) is worse in patients with type 2 diabetes than in age- and sex-matched controls. Patients with high perceived stress level have worse subjective sleep quality, higher use of sleeping medication, daytime dysfunction than patients with low perceived stress level; no significant differences in sleep quality between controls with high and low stress level. Perceived stress level in patients with type 2 diabetes is related to subjective sleep quality, sleep duration, use of sleep medication, daytime dysfunction, in age- and sex-matched controls-to daytime dysfunction.

Diabetes distress in males and females with type 1 diabetes in adolescence and emerging adulthood.

BACKGROUND: Age and gender are important factors in the adjustment and psychological well-being of patients with chronic physical illness. AIM: To explore the gender and age differences in diabetes distress between adolescents and emerging adults with type 1 diabetes (T1D). SUBJECTS AND METHODS: Diabetes distress was compared in 255 adolescents and 283 emerging adults with T1D using Problem Areas in Diabetes scale. RESULTS: High diabetes distress level was found in 22.8% of participants. Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.004), and overall score (18.75 vs 11.25, p=0.002) were higher in adult than in adolescent males, when adjusted for age at T1D onset. Negative emotional consequences (13.0 vs 10.0, p=0.005) and overall score (25.0 vs 20.0, p=0.016) were higher in adult compared to adolescent females, when adjusted for age at T1D onset. Lack of confidence in self-care (6.0 vs 3.0, p=0.002), negative emotional consequences (10.0 vs 6.0, p=0.015), and overall score (20.0 vs 11.2, p=0.005) were higher in adolescent females compared to males, when adjusted for age at T1D onset. Negative emotional consequences score was higher in adult females compared to males (13.0 vs 10.0, p=0.029), when adjusted for age at T1D onset. In conclusion, our findings show that patients with T1D have greater burden of diabetes distress in emerging adulthood than in adolescence and add to evidence suggesting the importance of addressing diabetes distress in clinical care and the necessity of wider picture beyond the physical manifestation of diabetes to be taken into consideration.

Diabetes distress in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood.

THE AIM: To determine whether or not diabetes distress varies by age of type 1 diabetes mellitus (T1DM) onset and/or gender. SUBJECTS AND METHODS: A total of 700 adult T1DM patients were randomly selected from the Lithuanian Diabetes Registry; 214 of them (30.6%) agreed to participate and were recruited for the study. Diabetes distress (emotional burden, physician-related distress, regimen-related distress, interpersonal distress) was compared in 105 (42 men and 63 women) patients with T1DM diagnosed during 0-18years of life, and in 109 (61 men and 48 women) with T1DM diagnosed in adulthood, using Diabetes Distress Scale (DDS). RESULTS: Adult childhood-onset T1DM women have higher regimen-related distress (36.3±21.3 vs 26.6±16.2, p=0.016) than adulthood-onset women. Adult childhood-onset T1DM women experience higher diabetes distress (higher emotional burden (27.0±22.0 vs 15.6±16.4, p=0.006), physician-related distress (34.4±33.9 vs 20.7±29.4, p=0.024), total diabetes distress (41.2±13.6 vs 34.8±10.9, p=0.011)) than childhood-onset men. Adulthood-onset T1DM women experience higher physician-related distress (39.2±37.6 vs 23.4±32.5, p=0.013), but lower regimen-related distress (26.6±16.2 vs 35.8±21.6, p=0.014) than adulthood-onset men. In conclusion our findings reinforce the interdependence of psychological and biomedical factors in influencing health outcomes and support the need to provide psychological assessment and support to patients with T1DM.

Profile of mood states in adult type 1 diabetes mellitus men and women with disease onset in childhood and in adulthood.

INTRODUCTION: Although diabetes may not be associated with psychopathology, it may be associated with less severe disturbances in psychosocial functioning. Emotional problems in relation to type 1 diabetes are usually analysed as symptoms of psychiatric conditions but not as states of mood. The aim was to compare profiles of mood states in adult patients with childhood-onset and adulthood-onset type 1 diabetes mellitus and to outline possible gender-specific differences. SUBJECTS AND METHODS: A total of 214 adult type 1 diabetic patients were randomly selected from the Lithuanian Diabetes Registry. The mood states were compared in 105 (42 men and 63 women) patients with type 1 diabetes diagnosed during 0-18 years of life and in 109 (61 men and 48 women) diagnosed in adulthood. The scores of tension-anxiety, depression-dejection, anger-hostility, vigour-activity, fatigue-inertia and confusion-bewilderment were evaluated using the Profile of Mood States. RESULTS: Depression-dejection was higher in adulthood-onset diabetic women than in childhood-onset (p=0.005) diabetic patients. In childhood-onset diabetic patients depression-dejection (p=0.046) and confusion-bewilderment (p=0.033) were higher in women than in men. Adulthood-onset women with diabetes had higher tension-anxiety (p=0.027), depression-dejection (p=0.001), and confusion-bewilderment (p=0.004) scores than men. Multiple logistic analyses showed that adulthood-onset period of type 1 diabetes is associated with higher levels of depression-dejection [OR=1.1; 95% confidence intervals (CI) 1.01-1.19, p=0.025], longer diabetes duration (OR=2.00; 95% CI 1.27-2.03, p=0.012), higher HbA1c level (OR=1.15; 95% CI 1.02-1.3, p=0.023), and female gender (OR=2.51; 95% CI 1.29-2.90, p=0.021). CONCLUSIONS: Profile of mood states in adult women with type 1 diabetes is worse than in men. Adulthood-onset type 1 diabetic women have higher depression-dejection than do childhood-onset diabetic patients. Adulthood-onset period of type 1 diabetes is associated with higher levels of depression-dejection, longer diabetes duration and female gender.

The effect of Ginkgo biloba and Camellia sinensis extracts on psychological state and glycemic control in patients with type 2 diabetes mellitus.

Interest in finding natural antioxidants for use in food or medical materials to prevent free radical imbalance has increased considerably over the past years. The aim of this research was to evaluate changes in glycemic control and psychological state of patients with type 2 diabetes mellitus (T2DM) after use of antioxidant plant preparations. Fifty-six patients with T2DM were randomly allocated to receive standardized Ginkgo biloba L. leaves dry extract, green tea dry extract, or placebo capsules. Diabetes glycemic control measured as glycated hemoglobin (HbA1c) level, antioxidant state and psychological data were evaluated at baseline, after 9 and 18 months of using either antioxidant preparations or placebo. The level of perceived stress lowered significantly after 9 months (p = 0.038) and 18 months (p = 0.030), and the psychological aspect of quality of life significantly improved after 18 months (p = 0.019) of use of G. biloba extrac. No significant differences were detected after using green tea extract. In patients using placebo, significant lowering of HbA1c level was observed after 18 months (p = 0.017). In conclusion, antioxidant G. biloba leaf extract exhibited a mild effect on psychological state and a trend of improving glycemic control in patients with type 2 diabetes mellitus.

The incidence of type 1 diabetes mellitus among 15-34 years aged Lithuanian population: 18-year incidence study based on prospective databases.

BACKGROUND: The aim of this prospective study was to determine the incidence of type 1 diabetes mellitus in 15-34-year-aged Lithuanian males and females during 1991 - 2008 METHODS: A contact system with general practitioners covering 100% of the 15-34-year-aged Lithuanian population was the primary data source. Reports from regional endocrinologists and statistical note-marks of State patient insurance fund served as secondary sources for case ascertainment. RESULTS: The average age-standardized incidence rate was 8.30 per 100,000 persons per year (95% Poisson distribution confidence interval [CI] 7.90-8.71) during 1991 - 2008 and was statistically significantly higher among males (10.44 per 100,000 persons per year, 95% CI 9.82-11.10) in comparison with females (6.10 per 100,000, 95% CI 5.62-6.62). Male/female rate ratio was 1.71 (95% CI 1.63-1.80). Results of the linear 1991 - 2008 regression model showed that the incidence of Type 1 diabetes in 15-34-year-aged males and females decreased slightly over the time (r = -0.215, p > 0.05). CONCLUSIONS: Our data demonstrated the male predominance in primary incidence of type 1 diabetes mellitus in 15-34-year-aged population in Lithuania. The incidence of type 1 diabetes mellitus in 15-34-year-aged males and females decreased slightly during 1991-2008.

Cognition, emotions and quality of life in Lithuanian girls with Turner syndrome after growth hormone therapy discontinuation.

OBJECTIVE: to examine cognitive functions, emotional state and quality of life of patients with Turner syndrome (TS) after growth hormone therapy discontinuation. PATIENTS AND METHODS: Anthropometric measurements, cognitive functioning, emotional state and quality of life of eighteen Lithuanian patients with TS were compared to that of age- and sex-matched controls. Height and weight of girls with TS were significantly lower than in the controls, though differences in body mass index were not significant. RESULTS: Tension-anxiety (10.61 +/- 7.21 vs. 6.72 +/- 3.98, p=0.02) and depression-dejection (14.72 +/- 11.87 vs. 8.49 +/- 6.29, p=0.02) were significantly higher, vigor-activity (13.05 +/- 4.77 vs. 16.13 +/- 4.36, p=0.04) was significantly lower and scores of cognitive functioning (53.18 +/- 29.46 vs. 26.79 +/- 7.31 and 96.94 +/- 44.59 vs. 58.07 +/- 15.43, p=0.001) were significantly higher (showing worse psychomotoric speed) in patients with TS than in the controls. Quality of life (9.53 +/- 5.19 vs. 6.35 +/- 4.19, p=0.03) in girls with TS was significantly worse than in healthy girls of the same age. CONCLUSION: patients with Turner syndrome are shorter, have lower weight, higher waist-to-hip ratio, impaired cognitive functions (worse psychomotoric speed), altered emotional state (higher tension-anxiety and depression-dejection, lower vigor-activity scores) and lower quality of life than age- and sex-matched controls.

[Associations of emotional state and quality of life with lipid concentration, duration of the disease, and the way of treating the disease in persons with type 2 diabetes mellitus]. / Serganciuju 2 tipo cukriniu diabetu emocines bukles ir gyvenimo kokybes sasajos su lipidu koncentracija, ligos trukme bei vartojamais vaistais.

The aim of the study was to evaluate associations of emotional state and quality of life with lipid concentration, duration of the disease, and the way of treating the disease in males and females with type 2 diabetes mellitus. A total of 53 persons with type 2 diabetes mellitus (27 males and 26 females; mean age, 58.7+/-8.9 years) and 56 healthy persons (26 males and 30 females; mean age, 54.7+/-8.3 years) participated in the study. Emotional state was evaluated by means of Profile of Mood State and quality of life by means of WHO Brief Quality of Life Questionnaire. Emotional state and quality of life were significantly worse, tension-anxiety and fatigue-inertia were significantly higher, vigor-activity was significantly lower in male patients with type 2 diabetes mellitus than in healthy males. In females, no significant differences in emotional state and quality of life comparing type 2 diabetes mellitus group and controls were detected. In females with type 2 diabetes mellitus, emotional state and quality of life were significantly better, scores of tension-anxiety, depression dejection, anger-hostility, and fatigue-inertia were significantly lower, and score of vigor-activity was significantly higher than in males with type 2 diabetes mellitus. Some significant correlations were found. In males, vigor-activity correlated with total cholesterol level and negatively correlated with triglyceride level. In females, significant correlations were found between scores of emotional state (tension-anxiety, depression-dejection, confusion-bewilderment, and total score of emotional state) and lipid levels (total cholesterol, triglyceride, and low-density lipoprotein cholesterol levels). There were no significant associations of emotional state and quality of life with duration of the disease in males and females with type 2 diabetes mellitus. No significant differences in emotional state and quality of life were found between males and females with type 2 diabetes mellitus, who were treated with oral antidiabetic preparations and insulin preparations.

Psychological state, quality of life, and body composition in postmenopausal women with osteoporosis in Lithuania.

SUMMARY: The objective of this study was to determine body composition, physical activity, and psychological state in postmenopausal women with osteoporosis. Fat mass, lean mass, water mass, and basal metabolic rate are lower, self-reported physical activity and risk factors of fractures are higher, and cognitive functions were worse in osteoporotic patients than in controls. Significant correlations were found between physical activity and emotional state parameters. INTRODUCTION: This study aims to determine peculiarities of body composition, physical activity, risk factors predicting fractures, psychological state and quality of life, and possible relations between them in postmenopausal women with osteoporosis in Lithuania. METHODS: Thirty-one postmenopausal women with osteoporosis and 29 healthy age- and sex-matched controls were included in the study. Profile of Mood State and Hospital Anxiety and Depression Scale were used for the assessment of emotional state. Trail Making Test and Digit Symbol Test of Wechsler Adult Intelligence Scale were used to evaluate cognitive functioning. Quality of life was evaluated using the World Health Organization Brief Quality of Life Questionnaire. Risk of fractures was assessed by the Risk Factors Predicting Questionnaire. RESULTS: Fat mass (22.4 +/- 4.7 vs. 40.6 +/- 14.2 kg, p < 0.001), lean mass (37.3 +/- 6.0 vs. 48.1 +/- 7.6 kg, p < 0.001), water mass (31.6 +/- 2.9 vs. 38.3 +/- 5.3 kg, p < 0.001), and basal metabolic rate (1,253 +/- 132 vs. 1,456 +/- 126 kcal, p < 0.001) were lower in osteoporotic patients than in controls. Self-reported physical activity (2.35 +/- 0.6 vs. 1.69 +/- 0.5, p < 0.001) and risk factors of fractures (5.9 +/- 2.1 vs. 2.6 +/- 2.4, p < 0.001) were higher in women with osteoporosis than in healthy age- and sex-matched controls (2.35 +/- 0.6 vs. 69 +/- 0.5, p < 0.001). Trail making A and B scores were higher in patients than in age- and sex-matched controls (55.8 +/- 19.9 vs. 45.1 +/- 19.9, p = 0.07 and 118.2 +/- 34.6 vs. 92.8 +/- 48.7, p = 0.006). Some significant correlations were detected between physical activity and emotional state and quality of life parameters. CONCLUSION: In postmenopausal women with osteoporosis, fat body mass, lean body mass, water body mass, basal metabolic rate, and waist-to-hip ratio are lower, physical activity and risk of fractures are higher, and cognitive functions are worse than in age- and sex-matched controls. Some psychological peculiarities could be related to physical activity in women with osteoporosis.

Psychological functioning after growth hormone therapy in adult growth hormone deficient patients: endocrine and body composition correlates.

Growth hormone replacement in adult growth hormone deficient patients improves psychological well-being and the quality of life. The aim of this study was to investigate relationship between changes in mood, cognitive functioning, quality of life, changes in body composition and hormone concentration at baseline and six months after treatment with human recombinant growth hormone. Eighteen adult patients with growth hormone deficiency syndrome were recruited to the study. Growth hormone was administered in doses of 12 IU per week in an open design. After 6 months of growth hormone replacement therapy the psychological functioning improved significantly on mood scales (Profile of Mood State) and on a cognitive performance tests. Changes in quality of life scale were trivial. After growth hormone treatment serum concentration of Insulin like growth factor -1 (IGF-1) and triiodothyronine increased and concentration of serum free thyroxine decreased significantly in comparison to basal concentration. There were no significant differences in changes of plasma cortisol, thyrotropin and growth hormone concentrations. Improvement on Profile of Mood State global score as well as on Vigor-Activity subscale correlated significantly with increase in IGF-1 concentration. Improvement on Profile of Mood State Vigor-Activity subscale correlated with increase in water body mass and improvement on Hospital Anxiety and Depression scale depression subscale correlated with decrease in cortisol concentration. The study shows that growth hormone replacement improves mood and cognition in adult growth hormone deficient patients. This improvement is related to changes in water body mass as well as to endocrine changes.