新研究发现,反复被恐慌侵扰的糖尿病的人多半是很少适当地管理疾病并且承受更严重的健康复杂并发症和更差的生活质量。

 Evette Ludman博士，西雅图健康合作组的一个研究人员，说她的组的以前的工作证明消沉与更多的糟糕控制的葡萄糖，更多的糖尿病症状，并且更低的工作关联很大。“但是因为恐慌和消沉经常一起出现，我们不肯定有的病人惊慌，独立于消沉，将也与这些有指示物。”
为新学习，它出现在医院将军精神病学的 11 月期，调查与糖尿病被寄给 4,385 个病人。那些参加者， (4.4%) 193 报导了有在行为引起了一个明确的变化的恐慌的事件。在 193 个病人之中， 54.5% 也有消沉的症状。
回答者们被向了解最近的恐慌或害怕“拼写”并且如果这些感情强迫了他们改变他们的行为。参加者也被给象他们工作和残疾的水平一样测量了他们的糖尿病症状的问询表。
那些与恐慌的混乱，平均 HbA1c 层次 - 长期的葡萄糖控制的一项措施 - 没有恐慌的事件，为那些与 7.7% 相比是 8.1% 。( 平常的治疗目标是低于 7% 保留层次 ) 也，没有恐慌，那些与恐慌的事件报导了在那些与 2.4 症状相比有 4.2 糖尿病症状的一般水准。
糖尿病患者被周期性的恐慌的侵扰，关于有另一攻击由坚持的担心列在后面。
作者说恐慌的症状可能自己就是是糖尿病的后果。恐慌的事件可以由防碍自顾和病人跟随他们的治疗整体的能力贡献差的结果。
如果与糖尿病对待病人的医生能更好认出并且对待恐慌的事件和消沉的症状，作者和糖尿病专家同意，他们能改进病人生活的质量。

“我认为最小心的临床医生注意了有些病人，不与他们的糖尿病处理很好并且包括恐慌的混乱，消沉，焦虑和个性混乱有许多 neuropsychosocial 问题，”医学博士约翰·布塞说，在小教堂希尔的北卡罗来纳的大学的糖尿病中心的部门首领。“钥匙确实到很小心地估计不在他们糖尿病或另外的长期的病的管理正在做很好的病人。”
原文:

Panic Attacks Can Increase Complications In Diabetes Patients

People with diabetes who have repeated panic attacks are less likely to have properly managed the disease and suffer more severe health complications and poorer quality of life, a new study finds.
Lead author Evette Ludman, Ph.D., a researcher with Group Health Cooperative in Seattle, said her group's previous work showed depression was associated with more poorly controlled glucose, more diabetes symptom, and lower functioning. "But because panic and depression so often go hand in hand, we weren't certain that patients who have panic, independent of depression, would also have with these indicators."
For the new study, which appears in the November issue of General Hospital Psychiatry, a survey was mailed to 4,385 patients with diabetes. Of those participants, 193 (4.4 percent) reported having panic episodes that caused a definite change in behavior. Among the 193 patients, 54.5 percent also had symptoms of depression.
Respondents were asked about recent panic or fear "spells" and if these feelings forced them to change their behavior. Participants were also given questionnaires that measured their diabetes symptoms as well as their level of functioning and disability.
Of those with panic disorder, the average HbA1c levels - a measure of long-term glucose control - were 8.1 percent compared with 7.7 percent for those without panic episodes. (Usual treatment goal is to keep levels below 7 percent.) Also, those with panic episodes reported having an average of 4.2 diabetes symptoms compared with 2.4 symptoms in those without panic.

Panic disorder is characterized by recurrent panic attacks, followed by persistent worry about having another attack.
The authors say that panic symptoms might be a consequence of diabetes itself. Panic episodes may contribute to poor outcomes by interfering with self-care and patients' ability to follow their treatment regimens.
The authors and diabetes experts agree that if physicians treating patients with diabetes can better recognize and treat the symptoms of panic episodes and depression, they can improve the patients' quality of life.
"I think most careful clinicians have noted that there are patients who do not cope well with their diabetes and have a variety of neuropsychosocial issues including panic disorder, depression, anxiety and personality disorders," said John Buse, M.D., division chief of the Diabetes Center at University of North Carolina at Chapel Hill. "The key really is to very carefully assess patients who are not doing well in their management of diabetes or other chronic illness."
General Hospital Psychiatry is a peer-reviewed research journal published bimonthly by Elsevier Science. For information about the journal, contact Wayne Katon, MD, at (206) 543-7177.
Ludman E, et al. Panic episodes among patients with diabetes. General Hospital Psychiatry 28: 475-481, 2006.
Ludman E

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