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Suresh Rama Chandran  (Chandran SR) 1 Article
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Persistent Anxiety Is Associated with Higher Glycemia Post-Transition to Adult Services in Asian Young Adults with Diabetes
Ling Zhu, Suresh Rama Chandran, Wee Boon Tan, Xiaohui Xin, Su-Yen Goh, Daphne Su-Lyn Gardner
Diabetes Metab J. 2021;45(1):67-76.   Published online June 15, 2020
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There is little longitudinal information on psychological burden and metabolic outcomes in young adults with diabetes (YAD) in Asia. We aimed to evaluate the association between psychological status and glycemia at baseline and 2 years following transition in a cohort of YAD in Singapore.


Subjects with type 1 diabetes mellitus (T1DM) and type 2 diabetes mellitus (T2DM), aged 17 to 25 years, were recruited from the YAD clinic in Singapore General Hospital. The Hospital Anxiety and Depression and Problem Areas for Diabetes scales were administered at transition (baseline) and at 18 to 24 months. Glycosylated hemoglobin (HbA1c) assessed during routine visits was tracked longitudinally.


A total of 98 T1DM (74.8%) and 33 T2DM (25.2%) subjects were recruited between January 2011 and November 2017. At baseline, mean HbA1c was 8.6%±1.7%. Only 26.0% achieved HbA1c of ≤7.5% and 16.8% achieved HbA1c of <7%. At baseline, prevalence of anxiety was 29.8%. At 24 months, 14.1% had persistent anxiety. Those with persistent anxiety had the highest mean HbA1c, particularly at 6 months (persistently anxious vs. persistently non-anxious: 9.9%±1.2% vs. 8.2%±1.9%, P=0.009). At baseline, 9.2% of subjects had depression. This group also had poorer glycemia at baseline (HbA1c of depressed vs non-depressed: 9.6%±2.1% vs. 8.5%±1.6%, P=0.04), which persisted up to 24 months.


The majority of YAD in Singapore have suboptimal glycemia. Psychological distress is a critical harbinger of poorer metabolic outcomes.


Citations to this article as recorded by  
  • The Cost-Effectiveness of an Advanced Hybrid Closed-Loop System Compared to Standard Management of Type 1 Diabetes in a Singapore Setting
    Daphne Gardner, Mrinmayee Lakkad, Zhiyu Qiu, Yuta Inoue, Suresh Rama Chandran, Kael Wherry
    Diabetes Technology & Therapeutics.2024; 26(5): 324.     CrossRef
  • Impact of diabetes distress on glycemic control and diabetic complications in type 2 diabetes mellitus
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    Scientific Reports.2024;[Epub]     CrossRef
  • The Interaction of Glycemia with Anxiety and Depression Is Related to Altered Cerebellar and Cerebral Functional Correlations
    Grace E. Shearrer
    Brain Sciences.2023; 13(7): 1086.     CrossRef
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    Psychoneuroendocrinology.2023; 158: 106357.     CrossRef
  • Increased Levels of Serum Glycosylated Hemoglobin are Associated with Depressive Symptoms in a Population with Cancer (≥49 Years): An Antidepressant-Stratified Analysis
    Ying Huang, Yilin Xu, Anwen Liu
    Clinical Interventions in Aging.2021; Volume 16: 205.     CrossRef
  • The Burden of Type 2 Diabetes and the Value of Achieving Near Normoglycemia from the Patient Perspective
    Heather Gelhorn, Zaneta Balantac, Shraddha Shinde, Vivian Thuyanh Thieu, Kristina S. Boye
    Diabetes Therapy.2021; 12(7): 1821.     CrossRef

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