与 1 型糖尿病患者胰岛素不依从相关的因素。
Factors associated with non-adherence to insulin in patients with type 1 diabetes.
机构信息
Musarrat Riaz, FCPS, Consultant Physician, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University. Plot No. 1-2, II-B, Nazimabad No2, Karachi-74600, Pakistan.
Abdul Basit, FRCP, Professor of Medicine, Department of Medicine, Baqai Institute of Diabetology and Endocrinology, Baqai Medical University. Plot No. 1-2, II-B, Nazimabad No2, Karachi-74600, Pakistan.
出版信息
Pak J Med Sci. 2014 Mar;30(2):233-9.
OBJECTIVES
To find out the various factors associated with non-adherence to diet, physical activity and insulin among patients with type 1 diabetes. (T1DM).
METHODS
This cross sectional study was conducted among T1DM subjects attending the Baqai Institute of Diabetology & Endocrinology (BIDE) and Diabetic Association of Pakistan (DAP), from July 2011 to June 2012.Clinical characteristics, anthropometric measurements, knowledge regarding type 1 diabetes along with adherence to dietary advice, physical activity and insulin were noted on a predesigned questionnaire and score was assigned to each question. Patients were categorized as adherent or non-adherent on the basis of scores obtained. Statistical Package for Social Sciences (SPSS) for windows version 17.0 was used to analyze the data.
RESULTS
A total of 194 patients (Male 94, Female 100), with mean age of 17.9± 6.4 years, mean duration of diabetes 5.37±4.96 years (38.1% >5 yrs, 61.9% <5 yrs) were included in the study. One hundred and fourteen (58.5%) patients were non adherent to dietary advice, 82(42.3%) non adherent to physical activity while 88.1% respondents were non adherent to their prescribed insulin regimen. Factors associated with non-compliance were family type, occupation & educational level of respondent's parents, duration of T1DM, family history of diabetes, frequency of visits to diabetic clinic, knowledge regarding diabetes, lack of family support and fear of hypoglycemia.
CONCLUSION
Non adherence to prescribed treatment regimen in patient with TIDM is quite high. There is need to design strategies to help patients and their family members understand their treatment regimen in order to improve their adherence.
目的
找出与 1 型糖尿病（T1DM）患者饮食、体力活动和胰岛素不依从相关的各种因素。
方法
本横断面研究于 2011 年 7 月至 2012 年 6 月期间在拜盖伊糖尿病与内分泌学研究所（BIDE）和巴基斯坦糖尿病协会（DAP）就诊的 T1DM 患者中进行。记录临床特征、人体测量学测量、有关 1 型糖尿病的知识以及对饮食建议、体力活动和胰岛素的依从性，并在预先设计的问卷上评分。根据得分将患者分为依从或不依从。使用 Windows 版统计软件包（SPSS）17.0 分析数据。
结果
共有 194 名患者（男 94 名，女 100 名），平均年龄为 17.9±6.4 岁，糖尿病平均病程为 5.37±4.96 年（38.1%>5 年，61.9%<5 年）。研究中包括 114 名（58.5%）对饮食建议不依从的患者，82 名（42.3%）对体力活动不依从的患者，88.1%的患者对规定的胰岛素方案不依从。不遵医嘱的相关因素有家庭类型、父母的职业和教育程度、T1DM 病程、糖尿病家族史、就诊次数、对糖尿病的认识、缺乏家庭支持和对低血糖的恐惧。
结论
1 型糖尿病患者对规定治疗方案的依从性相当差。需要设计策略来帮助患者及其家属理解其治疗方案，以提高其依从性。
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