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住院糖尿病患者疾病进展水平的性别差异。

Gender discrepancies in the level of disease progression in hospitalized patients with diabetes.

作者信息

Washington Elmer L, Shen Jay J

机构信息

Aunt Martha's Youth Service Center Inc., Chicago Heights, Illinois. USA.

出版信息

Manag Care Interface. 2006 Oct;19(10):21-5.

Abstract

Diabetes is a widely recognized and common cause of mortality, morbidity, and excess cost in the health care system. Type 2 diabetes is specifically on the rise, particularly in association with the increasing obesity rate. Substantial literature has examined differences in behavior across genders and potential effect on disease. However, based on a literature review, little has been done to evaluate differences in patterns of diabetes related to inpatient care across genders and to link these differences with potential explanations related to differences in care-seeking behavior, treatment compliance, and lifestyle choices. This review and analysis of national inpatient data demonstrates substantial differences associated with gender in patterns of hospital-based care in patients with type 2 diabetes. Men are more likely to be admitted for diabetes-related conditions and to present with blood sugars at extreme levels, including acutely elevated and dangerous blood sugar levels. When considering these findings in conjunction with the existing literature, it can be concluded that these differences are primarily reflective of variances in care-seeking behavior and long-term adherence to prescribed medications. Policies that promote expansion of health care benefits to include coverage for men at risk for type 2 diabetes, aggressive education and treatment programs, and expanded prescription drug coverage are necessary to reduce gender discrepancies in patterns of hospitalization and to improve outcomes.

摘要

糖尿病是医疗保健系统中一个广为人知且常见的死亡、发病原因及额外费用来源。2型糖尿病尤其呈上升趋势,特别是与肥胖率不断上升相关。大量文献研究了不同性别之间的行为差异及其对疾病的潜在影响。然而,基于文献综述,几乎没有研究评估过不同性别在住院护理相关的糖尿病模式上的差异,也未将这些差异与寻求护理行为、治疗依从性及生活方式选择方面的差异相关的潜在解释联系起来。本次对全国住院数据的综述与分析表明,2型糖尿病患者在基于医院的护理模式上存在与性别相关的显著差异。男性因糖尿病相关病症入院的可能性更高,且血糖水平往往处于极端状态,包括血糖急剧升高且达到危险水平。结合现有文献考虑这些发现,可以得出结论,这些差异主要反映了寻求护理行为和长期遵医嘱用药方面的差异。为减少住院模式中的性别差异并改善治疗结果,有必要推行扩大医疗保健福利的政策,将处于2型糖尿病风险的男性纳入保险范围,开展积极的教育和治疗项目,并扩大处方药覆盖范围。

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