Shin Ji-Yeon, Shim Hye Young, Jun Jae Kwan
Department of Preventive Medicine, School of Medicine, Eulji University, Daejeon, Republic of Korea.
National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
PLoS One. 2014 Oct 14;9(10):e110412. doi: 10.1371/journal.pone.0110412. eCollection 2014.
This study aimed to determine and compare the prevalences of diabetes awareness, treatment, and adequate glycemic control among cancer survivors in a Korean population and two non-cancer control groups, comprising individuals without a history of cancer but with other chronic diseases (non-cancer, chronic disease controls) and individuals without a history of cancer or any other chronic disease (non-cancer, non-chronic disease controls).
We analyzed data from 2,660 subjects with prevalent diabetes (aged ≥30 years), who had participated in the 2007-2011 Korea National Health and Nutrition Examination Survey. Awareness was defined as a subject having been diagnosed with diabetes by a clinician. Treatment was defined as a subject who was taking anti-diabetic medicine. Adequate glycemic control was defined as a hemoglobin A1c level of <7%. Multivariable logistic regression and predictive margins were used to evaluate whether awareness, treatment, or adequate glycemic control differed among cancer survivors and the two non-cancer control groups.
Cancer survivors had greater awareness compared with the non-cancer, chronic disease and non-cancer, non-chronic disease control groups (85.1%, 80.4%, and 60.4%, respectively). Although the prevalences of treatment and adequate glycemic control were higher for survivors compared with the non-cancer, non-chronic disease controls, they were lower compared with the non-cancer, chronic disease controls. The prevalence of diabetes treatment was 67.5% for cancer survivors, 69.5% for non-cancer, chronic disease controls, and 46.7% for non-cancer, non-chronic disease controls; the prevalences of adequate glycemic control in these three groups were 31.7%, 34.6%, and 17.8%, respectively.
Cancer survivors were less likely than the non-cancer chronic disease subjects to receive diabetes management and to achieve adequate glycemic targets. Special attention and education are required to ensure that this population receives optimal diabetes care, and the systematic roles for primary care and specialist physicians need to be determined.
本研究旨在确定并比较韩国人群中癌症幸存者以及两个非癌症对照组(包括无癌症病史但患有其他慢性病的个体(非癌症、慢性病对照组)和无癌症病史或任何其他慢性病的个体(非癌症、非慢性病对照组))的糖尿病知晓率、治疗率和血糖控制达标率。
我们分析了2660名患有糖尿病(年龄≥30岁)且参与了2007 - 2011年韩国国家健康与营养检查调查的受试者的数据。知晓定义为受试者被临床医生诊断患有糖尿病。治疗定义为正在服用抗糖尿病药物的受试者。血糖控制达标定义为糖化血红蛋白水平<7%。使用多变量逻辑回归和预测边际来评估癌症幸存者与两个非癌症对照组在知晓率、治疗率或血糖控制达标率方面是否存在差异。
与非癌症、慢性病对照组和非癌症、非慢性病对照组相比,癌症幸存者的知晓率更高(分别为85.1%、80.4%和60.4%)。虽然与非癌症、非慢性病对照组相比,幸存者的治疗率和血糖控制达标率更高,但与非癌症、慢性病对照组相比则更低。癌症幸存者的糖尿病治疗率为67.5%,非癌症、慢性病对照组为69.5%,非癌症、非慢性病对照组为46.7%;这三组的血糖控制达标率分别为31.7%、34.6%和17.8%。
与非癌症慢性病患者相比,癌症幸存者接受糖尿病管理并实现血糖控制达标的可能性较小。需要给予特别关注和教育,以确保该人群获得最佳的糖尿病护理,并且需要确定初级保健医生和专科医生的系统作用。