The psychological burden experienced by people with diabetes prior to islet transplantation is recognized but has not been studied comprehensively, especially in relation to glycemia. Therefore, we conducted a rigorous pre-operative psychosocial profile of UK islet transplant recipients, and compared groups with higher/lower HbA1 c to test the null hypothesis that pre-transplant hypoglycemia awareness and psychosocial burden would not be related to baseline HbA1 c in this high-risk cohort. Pre-transplant, recipients (n = 44) completed validated hypoglycemia awareness questionnaires and generic/diabetes-specific measures of psychological traits and states. Scores were compared in groups, dichotomized by HbA1 c (≤8% versus >8%). Participants were aged (mean±SD) 53 ± 10 years; 64% were women; with HbA1 c 8.3 ± 1.7%. Median rate of severe hypoglycemia over the preceding 12 months was 13 events/person-year and 90% had impaired awareness of hypoglycemia (Gold/Clarke score ≥4). Participants had elevated fear of hypoglycemia (HFS-II Worry), impaired diabetes-specific quality of life (DQoL) and low generic health status (SF-36; EQ-5D). One quarter reported scores indicating likely anxiety/depression (HAD). Dispositional optimism (LOT-R) and generalized self-efficacy (GSE) were within published ‘norms.’ Despite negative perceptions of diabetes (including low personal control), participants were confident that islet transplantation would help (BIPQ). Hypoglycemia awareness and psychosocial profile were comparable in lower (n = 24) and higher (n = 20) HbA1 c groups. Islet transplant candidates report sub-optimal generic psychological states (anxiety/depressive symptoms), health status and diabetes-specific psychological states (fear of hypoglycemia, diabetes-specific quality of life). While their generic psychological traits (optimism, self-efficacy) are comparable with the general population, they are highly optimistic about forthcoming transplant. HbA1 c is not a proxy measure of psychosocial burden, which requires the use of validated questionnaires to systematically identify those who may benefit most from psychological assessment and support.

糖尿病患者在胰岛移植前所经历的心理负担已得到认可，但尚未进行全面研究，尤其是与血糖相关的研究。因此，我们对英国胰岛移植受者进行了严格的术前社会心理分析，并比较了 HbA1c 较高/较低的组，以检验移植前低血糖意识和社会心理负担与本研究中基线 HbA1c 无关的无效假设。高危人群。移植前，接受者 (n = 44) 完成了经过验证的低血糖意识问卷和心理特征和状态的通用/糖尿病特定测量。分组比较分数，按 HbA1 c （≤8% 与 >8%）二分。参与者年龄（平均值±标准差）53±10岁；64% 是女性；HbA1 c 8.3 ± 1.7%。过去 12 个月内发生严重低血糖的中位数为 13 次事件/人年，90% 的人对低血糖的认识受损（Go​​ld/Clarke 评分≥4）。参与者对低血糖的恐惧升高（HFS-II Worry）、糖尿病特异性生活质量（DQoL）和一般健康状况不佳（SF-36；EQ-5D）。四分之一报告的分数表明可能存在焦虑/抑郁 (HAD)。性格乐观 (LOT-R) 和广义自我效能感 (GSE) 在已公布的“规范”内。尽管对糖尿病有负面看法（包括个人控制能力低），但参与者相信胰岛移植会有所帮助（BIPQ）。在较低 (n = 24) 和较高 (n = 20) HbA1 c 组中，低血糖意识和社会心理特征具有可比性。胰岛移植候选者报告了次优的一般心理状态（焦虑/抑郁症状）、健康状况和糖尿病特有的心理状态（对低血糖的恐惧、糖尿病特有的生活质量）。虽然他们的一般心理特征（乐观、自我效能）与一般人群相当，但他们对即将到来的移植手术非常乐观。HbA1 c 不是心理社会负担的替代衡量标准，它需要使用经过验证的问卷来系统地确定那些可能从心理评估和支持中受益最大的人。他们对即将到来的移植非常乐观。HbA1 c 不是心理社会负担的替代衡量标准，它需要使用经过验证的问卷来系统地确定那些可能从心理评估和支持中受益最大的人。他们对即将到来的移植非常乐观。HbA1 c 不是心理社会负担的替代衡量标准，它需要使用经过验证的问卷来系统地确定那些可能从心理评估和支持中受益最大的人。