Tuesday, April 17, 2012

Patient Surveys: Day 17

There were few patients seen today who match the inclusion criteria for my study  only three patients were interviewed today. The results of the surveys have been compiled below.




Entirely coincidentally, Patients 44 through 46 have very similar data. They're approximately the same age, have Type 2 diabetes, have an HbA1c level between 8.0% and 8.1%, and obtained a score of 0 on PHQ-9. The vast majority of the Type 2 diabetics that I have surveyed have data that is practically identical to that of these three patients. As the conclusion of my project is approaching, I think there is a clear trend to be observed with the Type 2 diabetics: Type 2 diabetics tend to have lower HbA1c levels and PHQ-9 scores than their Type 1 counterparts.

At first glance, this still doesn't account for why the Type 2 diabetic's PHQ-9 scores don't reflect how uncontrolled each patient's diabetes is.Technically, their HbA1c level lies in the "American Diabetes Association recommends reevaluation of therapy" category. So if there is indeed any positive correlation between diabetes and depression, why wouldn't their PHQ-9 scores be greater than 0 if their HbA1c is considered high?

Earlier in March when I first noted this observation, having surveyed merely four patients, I suggested the following: "It follows that Type 1 diabetics would have a more difficult time maintaining glycemic control because Type 2 diabetics do not require as much of an active individual role in controlling their diabetes (e.g. Type 2 diabetics do not have to constantly monitor blood sugar levels and administer insulin appropriately)." Now, over a month later, I feel that the data of my new forty-two new patients can still attest to this: even if the HbA1c level of a Type 2 diabetic is "high," it's not necessarily as severe (and perhaps, as a result, as anxiety-inducing or depression-invoking) as it would be with a Type 1 diabetic with the same HbA1c level. This could be, as my aforementioned hypothesis suggests, because the latter would require much more of an active role to bring their blood sugar under control, i.e. the Type 1 patient would have a more difficult (and assumedly, a more stressful) time maintaining glycemic control.

Lalani.

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