Analysis Of Influencing Factors Of Anxiety And Depression In Patients With Type 2 Diabetes Mellitus And Study On The Effect Of Psychological Counseling Management

Objective:In this study,we evaluated the incidence of Anxiety and Depression in patients with Type 2 Diabetes Mellitus(T2DM).And we tried to analyze the influencing factors of Anxiety and Depression in patients with Type 2 Diabetes.The psychological counseling and intervention management were conducted for the T2 DM patients,accompanied by mild to moderate anxiety and depression.Then the anxiety-depression status and Hb A1 c level of the T2 DM patients were observed before and after the intervention.Furthermore,we evaluated glycemic control of the T2 DM patients based on these indicators.Methods:A total of 287 T2 DM patients who were admitted to the Department of Endocrinology of Bengbu Community Hospital and the First Affiliated Hospital of Bengbu Medical College from November 2019 to June 2020 were investigated for their medical records and structured questionnaires.Completed HADS scale assessment and socio-demographic and health data collection.Assessed the incidence of T2 DM associated with anxiety and depression.Finally,93 questionnaires of the anxiety and depression group and 108 questionnaires of the non-anxiety and depression group were effectively collected.And these factors collected from socio-demographic and health data,such as gender,age,course of disease,education level,marriage,hemoglobin A1c(Hb A1c),and complications were selected to analyze the main factors which influenced the occurrence of anxiety and depression.Among the above cases of T2 DM patients with mild to moderate anxiety and depression(7 < A/D < 14),25 patients aged between 45 and 55 years were selected,and these patients were randomly divided into the intervention group and the control group.Patients in the intervention group were received psychological counseling intervention every 2 months for 6 months.After 6 months,HADS scale and glycosylated hemoglobin of the patients were determination.Finally,we analyzed the anxiety-depression status and the Hb A1 c changes of patients before and after intervention to understand the control of blood glucose in the patients.Results:Among 201 T2 DM patients,the incidence of anxiety and depression was as high as 46.3%.Among the influencing factors,age,course of disease,Hb A1 c,the number of complications and complications were significantly correlated with the incidence of anxiety and depression in the T2 DM patients(P < 0.05).In the multiple Logistic regression analysis,the course of disease,Hb A1 c,diabetic nephropathy and other factors were the risk factors for the occurrence of anxiety and depression in T2 DM patients.After psychological counseling and management intervention,HAS(anxiety value)and HDS(depression value)of the HADS scale in T2 DM patients decreased both in the intervention group and the control group.But only the intervention group showed statistically significant difference before and after the intervention(P < 0.05).At the same time,the Hb A1 c value in both groups decreased compared with before intervention,but only the Hb A1 c value in the intervention group decreased significantly after intervention(P < 0.05).Conclusion:The type 2 diabetes patients have a high incidence of anxiety and depression,and they have a poor psychological state,which is affected by the patient’s course of disease,number of diabetes complications and complications,Hb A1 c and other related factors.In the treatment of T2 DM patients with anxiety and depression disorder,adding psychological counseling intervention management will be conducive to the adjustment of patients’ psychological state,and more conducive to regulate patients’ blood sugar.