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The psychopathology of recurrent diabetic ketoacidosis: a case-control study

Garrett, C; Moulton, CD; Choudhary, P; Amiel, S; Fonagy, P; Ismail, K; (2020) The psychopathology of recurrent diabetic ketoacidosis: a case-control study. Diabetic Medicine , Article e14505. 10.1111/dme.14505. (In press). Green open access

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Abstract

BACKGROUND: Despite its poor prognosis, the psychological factors associated with recurrent diabetic ketoacidosis are poorly understood. In people with type 1 diabetes, we assessed for psychopathology in those with and without recurrent DKA. METHOD: The design was a case-control study. Cases were defined as people with two or more DKA episodes in a 12-month period (recurrent DKA). Cases and controls were matched for gender and age. We compared groups for scores on Beck's Anxiety Inventory (BAI), Beck's Depression Inventory II (BDI-II), Difficulty in Emotion Regulation Scale (DERS), Experiences in Close Relationships-Revised (ECR-R), Standardised Assessment of Personality-Abbreviated Scale (SAPAS), Interpersonal Problem Inventory (IIP-32), Eating Disorder Examination Questionnaire (EDE-Q) and Problem Areas in Diabetes (PAID) using unpaired t-tests or Mann-Whitney U tests for parametric- and non-parametric data respectively. Correction was made for multiple testing. RESULTS: Twenty-three cases and 23 controls were recruited with mean age 31.0 (11.4) years and 65.2% were men. Cases had higher HbA1c levels than controls (101.1 (23.2) vs 85.7 (21.7) mmol/mol, p=0.02. Compared to controls, people with recurrent DKA had higher scores on the BAI (p=0.004), PAID (p=0.004), DERS (p=0.001) and SAPAS (p<0.001). Sixteen of 23 (69.6%) cases screened positive for a personality disorder compared to 6 of 23 (26.1%) controls. CONCLUSIONS: People with recurrent DKA have elevated levels of anxiety and diabetes distress, greater difficulty with emotion regulation and personality dysfunction compared to matched controls.

Type: Article
Title: The psychopathology of recurrent diabetic ketoacidosis: a case-control study
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/dme.14505
Publisher version: http://dx.doi.org/10.1111/dme.14505
Language: English
Additional information: © 2020 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
Keywords: other complications, psychological aspects, health care delivery
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10118501
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