Introduction A triple disaster struck eastern Japan in March 2011. We investigated the psychological distress and post-traumatic stress disorder (PTSD) symptoms caused by the disaster in people without or with diabetes mellitus. Research design and methods This cross-sectional analysis examined the 16 097 evacuees (1820 (11.3%) with and 14 277 (88.7%) without diabetes mellitus) included in the Fukushima Health Management Survey. Non-specific mental health distress was assessed using the Kessler-6 Scale, and traumatic symptoms were evaluated using the PTSD Checklist. Logistic regression analyses were used to estimate the OR and 95% CI associated with symptoms, adjusted for diabetes-related and disaster-related factors. Results In the age-adjusted and sex-adjusted logistic models, suboptimal diabetic control (hemoglobin A1c (HbA1c) ≥7%) was associated with both psychological distress and possible PTSD. In the same models, current smoking, evacuation, and sleep dissatisfaction were associated with psychological distress and possible PTSD. In the multivariate-adjusted logistic models, HbA1c ≥7% was associated with psychological distress, independent of job change, evacuation, or sleep dissatisfaction. Conclusion After the triple disaster, non-specific mental health distress was associated with suboptimal diabetic control. Thus, patients with diabetes, especially those with suboptimal diabetic control, may be vulnerable to postdisaster psychological burden. Data are available upon reasonable request. The data that support the findings of this study are available from the corresponding author upon reasonable request.

中文翻译：

---

日本三重灾难后的次优糖尿病控制和心理负担：福岛健康管理调查

简介 2011 年 3 月，日本东部发生了三重灾难。我们调查了这场灾难对没有或患有糖尿病的人造成的心理困扰和创伤后应激障碍 (PTSD) 症状。研究设计和方法 本横断面分析调查了福岛健康管理调查中包括的 16097 名撤离人员（1820 名（11.3%）和 14277 名（88.7%）没有糖尿病）。使用 Kessler-6 量表评估非特定心理健康困扰，使用 PTSD 检查表评估创伤症状。Logistic 回归分析用于估计与症状相关的 OR 和 95% CI，并根据糖尿病相关和灾难相关因素进行调整。结果 在年龄调整和性别调整的逻辑模型中，次优的糖尿病控制（血红蛋白 A1c (HbA1c) ≥ 7%）与心理困扰和可能的 PTSD 相关。在相同的模型中，当前吸烟、疏散和睡眠不满意与心理困扰和可能的 PTSD 相关。在多变量调整的逻辑模型中，HbA1c ≥ 7% 与心理困扰相关，与工作变化、疏散或睡眠不满意无关。结论 三重灾难后，非特异性心理健康困扰与次佳的糖尿病控制有关。因此，糖尿病患者，尤其是糖尿病控制不佳的患者，可能容易受到灾后心理负担的影响。可应合理要求提供数据。支持本研究结果的数据可根据合理要求从通讯作者处获得。