The relationship between well‐being and HbA1c in adults with type 1 diabetes: A systematic review

• Published in: Journal of diabetes Vol. 15; no. 2; pp. 152 - 164
• Main Authors: Pérez‐Fernández, Aida, Fernández‐Berrocal, Pablo, Gutiérrez‐Cobo, María José
• Format: Journal Article
• Language: English
• Published: Melbourne Wiley Publishing Asia Pty Ltd 01-02-2023; John Wiley & Sons, Inc
• Subjects: 1型糖尿病; Adult; Adults; affective well‐being; cognitive well‐being; Diabetes; Diabetes Mellitus, Type 1 - complications; Disease management; Glucose; Glycated Hemoglobin; HbA1c; Humans; Hyperglycemia - complications; Mental health; Original; Psychological Well-Being; Quality of life; Systematic review; type 1 diabetes; 情感幸福感; 糖化血红蛋白; 系统综述; 认知幸福感; type 1 diabetes; affective well-being; 系统综述; cognitive well-being; 认知幸福感; 1型糖尿病; systematic review; HbA1c; 情感幸福感; 糖化血红蛋白
• DOI: 10.1111/1753-0407.13357
• EISSN: 1753-0407
• ISSN: 1753-0393

Background
Diabetes has been associated with psychological problems, which in turn have been related to poorer glycemic control (glycosylated hemoglobin [HbA1c]). On the contrary, psychological well‐being constructs have been associated with superior medical outcomes, including better HbA1c.
Aim
The main objective of this study was to systematically review the existing literature about the relationships between subjective well‐being (SWB) and HbA1c in adults with type 1 diabetes (T1D).
Methods
Comprehensive searches were conducted in PubMed, Scopus, and Medline, time restricted to 2021, for studies examining the link between HbA1c and the cognitive (CWB) and affective (AWB) components of SWB. A total of 16 eligible studies were selected according to the inclusion criteria, of which 15 measured CWB and 1 AWB.
Results
Of the 15 studies included, 11 showed a relationship between CWB and HbA1c, with a higher level of HbA1c being related to poorer CWB. The other four studies did not find any significant association. Finally, the only study examining the relationship between AWB and HbA1c found a marginally association between these variables in the expected direction.
Conclusion
The overall data suggest that CWB is negatively related to HbA1c in this population, but these results are inconclusive. This systematic review offers clinical implications, such as the possible evaluation, prevention, and treatment of the problems associated with diabetes through the study and training of the psychosocial variables that may directly influence SWB. Limitations and future lines of investigation are discussed.
摘要
背景:糖尿病常伴有心理问题, 而心理问题又与血糖控制(HbA1c)不佳相关。相反, 心理健康与较好的医疗结局(包括较好的HbA1c)相关。本研究旨在系统回顾关于成人1型糖尿病(T1D)患者主观幸福感(SWB)和HbA1c之间关系的现有文献。
方法:检索PubMed,Scopus和Medline, 时间限制至2021年, 以研究HbA1c与主观幸福感的认知(CWB)和情感(AWB)成分之间的关系。根据纳入标准共筛选出符合条件的研究16篇, 其中测量CWB 15篇, AWB 1篇。
结果:共纳入15项研究, 其中11项研究显示CWB与HbA1c相关, HbA1c水平越高, CWB越差。其他四项研究未发现任何显著关联。最后, 仅一项研究探讨了AWB和HbA1c之间的关系, 结果发现这些变量在预期方向上略有关联。
结论:总体数据提示CWB与该人群HbA1c呈负相关, 但结果尚不明确。这篇系统综述提供了临床意义, 例如通过对可能直接影响主观幸福感的社会心理变量的研究和培训, 与糖尿病相关的问题可能的评估、预防和治疗。同时讨论了研究的局限性和未来的研究方向。
Highlights
Subjective well‐being (SWB) is an important variable to consider, given its association with positive outcomes in people with diabetes and the general population.
The main aim of this study is to systematically review how SWB factors are related to type 1 diabetes management through the glycosylated hemoglobin (HbA1c) index in adults.
The overall data suggested that the cognitive well‐being is negatively related to HbA1c in this population, but these results are inconclusive.