Kutob Randa M, Siwik Violet Perez, Aickin Mikel, Ritenbaugh Cheryl
The Department of Family and Community Medicine, Arizona Health Sciences Center, University of Arizona College of Medicine, Tucson, Arizona, USA
Diabetes Educ. 2014 Mar-Apr;40(2):191-201. doi: 10.1177/0145721714520722. Epub 2014 Jan 24.
The purpose of the Families United/Familias Unidas study was to evaluate the feasibility and efficacy of group office visits on reducing diabetes risk in a multiethnic, primary care population.
Adults, ages 18 to 70 years, with any diabetes risk factor were recruited to attend 12 group office visits over 6 months. Each participant identified 1 support person, age 14 to 70 years, to accompany them. Data were collected at baseline, postintervention, 6 months, and 12 months. Primary outcome measures were reduction in the total number of predefined, modifiable risk factors (ie, body mass index ≥25 kg/m(2); waist circumference ≥88 cm [women], ≥102 cm [men]; blood pressure ≥140/90 mm Hg; hemoglobin A1C ≥5.7%; fasting insulin ≥15 µU/mL; glycemic index ≥52.5% [women], ≥53.4% [men]; and physical activity <150 min/wk).
Thirty-nine participants/supporters completed the intervention (mean age 47.8 ± 12.3 years, 69.2% female, 61.5% white, 35.9% Latino). Risk reduction analysis included only participants/supporters who remained paired at the intervention's end (n = 36). At baseline, primary participants (n = 18) had an average of 4.8 ± 1.6 (standard error) predefined risk factors; supporters (n = 18), 4.1 ± 1.4. Primary participants' risk factors decreased approximately 15% immediately after the 6-month intervention (absolute reduction of 1.1 risk factors) and increased to ~20% reduction 1 year postintervention (absolute reduction of 1.4 risk factors). Risk reduction was primarily due to decreases in dietary glycemic index and fasting insulin levels.
Group visits provide an innovative and potentially efficacious model of diabetes prevention in multiethnic patients with heterogeneous risk factors.
“家庭联合/家人团结”研究的目的是评估团队门诊对降低多民族初级保健人群糖尿病风险的可行性和有效性。
招募年龄在18至70岁之间、有任何糖尿病风险因素的成年人，在6个月内参加12次团队门诊。每位参与者指定一名年龄在14至70岁之间的支持人员陪同。在基线、干预后、6个月和12个月时收集数据。主要结局指标是预定义的可改变风险因素总数的减少（即体重指数≥25kg/m²；腰围≥88cm[女性]，≥102cm[男性]；血压≥140/90mmHg；糖化血红蛋白≥5.7%；空腹胰岛素≥15µU/mL；血糖指数≥52.5%[女性]，≥53.4%[男性]；以及身体活动<150分钟/周）。
39名参与者/支持者完成了干预（平均年龄47.8±12.3岁，69.2%为女性，61.5%为白人，35.9%为拉丁裔）。风险降低分析仅包括在干预结束时仍配对的参与者/支持者（n=36）。在基线时，主要参与者（n=18）平均有4.8±1.6（标准误）个预定义风险因素；支持者（n=18）为4.1±1.4个。主要参与者的风险因素在6个月干预后立即下降了约15%（绝对减少1.1个风险因素），在干预后1年增加到约20%的降低（绝对减少1.4个风险因素）。风险降低主要归因于饮食血糖指数和空腹胰岛素水平的下降。
团队门诊为具有异质性风险因素的多民族患者提供了一种创新且可能有效的糖尿病预防模式。
