Centre for Studies in Family Medicine, Department of Family Medicine, Schulich School of Medicine and Dentistry, 245-100 Collip Circle, UWO Research Park, The University of Western Ontario, London, Ontario N6G 4X8, Canada.
Diabetes Res Clin Pract. 2011 May;92(2):272-9. doi: 10.1016/j.diabres.2011.02.006. Epub 2011 Mar 3.
The aim of this cross-sectional study was to document the clinical management of type 2 diabetes and related complications in Canada's First Nations.
Patients were randomly selected from 19 communities. Data from charts from consenting patients were collected.
Of 885 patients, 63.3% were female, mean age was 54.9 years and mean duration of T2DM was 11.2 years. Mean A1C was 8.2%; 61.1% of patients had an A1C >7.0%; mean LDL was 2.4 mmol/L; 92.6% had dyslipidemia; mean systolic BP was 132 mm Hg; mean diastolic BP was 76 mm Hg; 92.0% had hypertension. Lipid-lowering medications were prescribed to 62.9% of those with dyslipidemia and an LDL-C >2.0 mmol/L. Of hypertensive patients, 15.8% were not on an antihypertensive agent. For vascular protection, 55.1% were on a statin, 72.1% on an ACE inhibitor or ARB, and 64.5% on an anticoagulant. Smoking was documented in 39.4%, 92.1% were overweight/obese; 55.1% had chronic kidney disease, and 13.3% had coronary artery disease.
Major care gaps were revealed, with most patients not achieving glycemic, lipid and BP targets. Over half of this relatively young cohort had established microvascular disease. Macrovascular disease rates may increase dramatically due to the high prevalence of risk factors.
本横断面研究旨在记录加拿大第一民族中 2 型糖尿病及其相关并发症的临床管理情况。
从 19 个社区中随机选择患者。从同意参与的患者的病历中收集数据。
在 885 名患者中，63.3%为女性，平均年龄为 54.9 岁，2 型糖尿病的平均病程为 11.2 年。平均 A1C 为 8.2%；61.1%的患者 A1C>7.0%；平均 LDL 为 2.4mmol/L；92.6%的患者存在血脂异常；平均收缩压为 132mmHg；平均舒张压为 76mmHg；92.0%的患者患有高血压。对于血脂异常且 LDL-C>2.0mmol/L 的患者，62.9%的患者开具了降脂药物。在高血压患者中，15.8%的患者未使用降压药物。为了血管保护，55.1%的患者使用了他汀类药物，72.1%的患者使用了 ACE 抑制剂或 ARB，64.5%的患者使用了抗凝药物。记录了 39.4%的吸烟情况，92.1%的患者超重/肥胖；55.1%的患者患有慢性肾脏病，13.3%的患者患有冠心病。
研究揭示了主要的护理差距，大多数患者的血糖、血脂和血压目标未得到控制。该相对年轻的患者队列中，超过一半的患者已经患有微血管疾病。由于危险因素的高患病率，大血管疾病的发病率可能会显著增加。
