Center for Disease Prevention and Health Interventions for Diverse Populations, Ralph H Johnson VA Medical Center, Charleston, South Carolina 29425-0593, USA.
Diabetes Technol Ther. 2010 Oct;12(10):785-90. doi: 10.1089/dia.2010.0040.
Veterans have a disproportionately higher burden of type 2 diabetes. It is unclear whether veterans with diabetes have better self-care behaviors or receive better quality of care than non-veterans. The objective was to examine differences in diabetes care between veterans and non-veterans.
Data analysis was performed with respondents from the 2003 Behavioral Risk Factor Surveillance Survey (n = 21,111 with diabetes). Veterans were those who reported U.S. military service and no longer on active duty. Self-care behaviors included daily fruit and vegetable intake, physical activity level, self-foot checks, and home glucose testing. Quality of care indicators included provider actions over the past 12 months (2+ office visits, 2+ glycosylated hemoglobin checks, 1+ foot exams, 1+ dilated eye exams, daily aspirin use, receiving flu or pneumonia vaccine). Multiple logistic regression using STATA version 10 (Stata Corp., College Station, TX) analyzed differences by veteran status on each quality indicator, controlling for sociodemographics and diabetes education.
Veterans comprised 14.2% of the sample, and 12.4% had diabetes compared to 6.7% of non-veterans. In final adjusted models, veterans were significantly more likely to check their feet (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.09, 1.64), get a dilated eye exam (OR 1.36, 95% CI 1.11, 1.66), receive aspirin (OR 1.31, 95% CI 1.04, 1.65), get a flu shot (OR 1.32, 95% CI 1.09, 1.61), and ever get a pneumonia shot (OR 1.38, 95% CI 1.12, 1.70).
Veterans appear to have better self-care behaviors and receive better preventive care than non-veterans. However, future efforts need to focus on boosting self-care to improve diabetes outcomes.
退伍军人 2 型糖尿病负担过重。目前尚不清楚患有糖尿病的退伍军人的自我护理行为是否更好，或者他们接受的护理质量是否优于非退伍军人。本研究旨在检查退伍军人和非退伍军人之间的糖尿病护理差异。
对 2003 年行为风险因素监测调查（n=21111 例糖尿病患者）的应答者进行数据分析。退伍军人是指曾有过美国兵役经历且不再服现役的人。自我护理行为包括每日摄入水果和蔬菜、身体活动水平、自我足部检查和家庭血糖检测。护理质量指标包括过去 12 个月内（2 次以上就诊、2 次以上糖化血红蛋白检查、1 次以上足部检查、1 次以上散瞳检查、每日服用阿司匹林、接种流感或肺炎疫苗）提供者的行为。使用 STATA 版本 10（StataCorp，College Station，TX）进行多变量逻辑回归分析，控制社会人口统计学和糖尿病教育因素后，根据退伍军人身份对每项质量指标的差异进行分析。
退伍军人占样本的 14.2%，12.4%的人患有糖尿病，而非退伍军人的这一比例为 6.7%。在最终调整后的模型中，退伍军人更有可能检查自己的足部（比值比[OR]1.33，95%置信区间[CI]1.09，1.64）、接受散瞳检查（OR 1.36，95% CI 1.11，1.66）、服用阿司匹林（OR 1.31，95% CI 1.04，1.65）、接种流感疫苗（OR 1.32，95% CI 1.09，1.61）和接种肺炎疫苗（OR 1.38，95% CI 1.12，1.70）。
退伍军人的自我护理行为似乎更好，接受的预防保健也更好，而非退伍军人则不然。然而，未来的工作需要集中精力提高自我护理水平，以改善糖尿病的结局。
