McClean Mary T, Andrews William John, McElnay James C
Clinical and Practice Research Group, School of Pharmacy, The Queen's University of Belfast, Belfast, Northern Ireland.
Pharm World Sci. 2005 Jun;27(3):154-8. doi: 10.1007/s11096-005-1190-6.
The incidence of diabetes is increasing worldwide and with it the risk of diabetic complications. The aim of this study was to characterise parameters associated with neuropathy and/or retinopathy in a hospital outpatient diabetic clinic population.
A structured questionnaire addressing diabetes related factors and demography was administered to a cross-sectional sample of patients (n = 290) with type 1 and type 2 diabetes attending a hospital diabetic outpatient clinic. Additional clinical measures were obtained from patient medical files and computerised records. Logistic regression analysis was used to identify characteristics associated with the presence of complications.
When controlling for other predictors, increasing age (P < 0.01), type 1 diabetes (P = 0.05), longer duration of diabetes (P < 0.01), increased serum triglyceride levels (P = 0.03), HbA1c (>8%; P = 0.03), self-reported low physical activity levels (P = 0.05) and being a smoker (P = 0.01) were positively related to retinopathy and/or neuropathy. Patients within the study population had reasonably well controlled BP and serum lipids, thus explaining the absence of these particular variables from the list of predictor parameters. Other factors including diabetes knowledge, home blood glucose monitoring, gender, body mass index, clinic attendance and occupational status were not significantly associated with retinopathy or neuropathy in the present study population.
Pharmacists and other health practitioners who are in a position to be involved in the care and management of patients with diabetes should raise awareness of complications, particularly amongst patients who present with the above risk factors and provide necessary counselling and advice as required.
全球糖尿病发病率不断上升,糖尿病并发症的风险也随之增加。本研究的目的是确定医院门诊糖尿病患者人群中与神经病变和/或视网膜病变相关的参数。
对一家医院糖尿病门诊的1型和2型糖尿病患者横断面样本(n = 290)进行了一份关于糖尿病相关因素和人口统计学的结构化问卷调查。从患者病历和计算机记录中获取了额外的临床测量数据。采用逻辑回归分析来确定与并发症存在相关的特征。
在控制其他预测因素时,年龄增加(P < 0.01)、1型糖尿病(P = 0.05)、糖尿病病程延长(P < 0.01)、血清甘油三酯水平升高(P = 0.03)、糖化血红蛋白(HbA1c)>8%(P = 0.03)、自我报告的低体力活动水平(P = 0.05)以及吸烟(P = 0.01)与视网膜病变和/或神经病变呈正相关。研究人群中的患者血压和血脂控制得较好,因此这些特定变量未出现在预测参数列表中。在本研究人群中,其他因素,包括糖尿病知识、家庭血糖监测、性别、体重指数、门诊就诊情况和职业状况,与视网膜病变或神经病变无显著关联。
能够参与糖尿病患者护理和管理的药剂师及其他健康从业者应提高对并发症的认识,尤其是在有上述危险因素的患者中,并根据需要提供必要的咨询和建议。