Department of Public Health, Kyorin University, School of Medicine, 6-20-2 Shinkawa Mitaka-City, 181-8611, Tokyo, Japan,
Environ Health Prev Med. 2006 May;11(3):115-9. doi: 10.1265/ehpm.11.115.
To investigate the personal features associated with dropout from regular outpatient care among persons with type 2 diabetes mellitus (DM).
A total of 160 DM patients were enrolled in the study. As a retrospective analysis, outpatient's clinical characteristics, lifestyle, or social features were gathered from their medical records or interview sheets. All the subjects were divided into two groups by adherence to diabetic care, namely, 'dropout case' (DC), or 'ongoing case' (OC), and were subjected to comparative analysis. We called the patients who did not receive outpatient treatment from the clinic on a regular basis, including treatment from other clinics or dropout of diabetic care, as DC. In contrast, patients who regularly visited the clinic were defined as OC. An unconditional multiple logistic regression analysis was performed to analyze the association of a dherence to diabetic care with several personal features.
Sixty-eight of 160 subjects (42.5%) were recognized as DC. The remaining 92 subjects (57.5%) were considered as OC. Young age (p=0.045), low plasma glucose (p=0.005) and hemoglobin A1c (HbA1c) levels (p=0.005), nonmedication (p<0.001) and no past history of DM (p=0.007) at the initial visit were the features related to dropout by crude analysis. Even after adjustment for age and gender by multivariate analysis, there remained significant inverse associations of dropout with HbA1c level, medical treatment (oral agents or insulin) and previous DM history. Neither occupation, distance from residence to clinic, smoking habit nor drinking habit was associated with dropout. Dropout mostly occurred after the initial or second visit.
A mild condition of DM may be related to dropout from regular outpatient care. It may be necessary to clearly show the objectives and importance of regular visit to an outpatient clinic for diabetic care, particularly for screened mild DM cases in public health activities.
探讨 2 型糖尿病（DM）患者常规门诊治疗中断的个体特征。
共纳入 160 例 DM 患者。作为回顾性分析，从病历或访谈表中收集门诊患者的临床特征、生活方式或社会特征。根据是否遵守糖尿病护理，将所有患者分为两组，即“脱落组（DC）”或“持续组（OC）”，并进行比较分析。我们将未定期在诊所接受门诊治疗的患者（包括在其他诊所接受治疗或停止糖尿病护理）称为 DC。相比之下，定期到诊所就诊的患者被定义为 OC。采用非条件多项逻辑回归分析，分析遵守糖尿病护理与个人特征的关联。
160 例患者中，68 例（42.5%）被确认为 DC。其余 92 例（57.5%）被认为是 OC。初步就诊时年龄较小（p=0.045）、血糖（p=0.005）和糖化血红蛋白（HbA1c）水平较低（p=0.005）、未用药（p<0.001）、无糖尿病既往史（p=0.007）是粗分析中与脱落相关的特征。即使在多变量分析中调整年龄和性别后，HbA1c 水平、医疗治疗（口服药物或胰岛素）和既往糖尿病史与脱落仍呈显著负相关。职业、居住地到诊所的距离、吸烟习惯或饮酒习惯与脱落无关。脱落大多发生在初次或第二次就诊后。
DM 病情较轻可能与常规门诊治疗中断有关。对于公共卫生活动中筛查出的轻度 DM 病例，可能有必要明确向患者展示定期到门诊就诊进行糖尿病护理的目标和重要性。
