Chew B H, Mastura I, Bujang M A
Department of Family Medicine, Faculty of Medicine & Health sciences, Universiti Putra Malaysia.
Klinik Kesihatan Seremban.
Malays Fam Physician. 2013 Dec 31;8(3):11-8. eCollection 2013.
We examined disease profiles of patients with type 2 diabetes mellitus (T2D) at four different public health facilities in Malaysia to determine which site would be the most suitable for early and intensive diabetes care against diabetes-related complications.
This study analysed 57,780 T2D patients in the Adult Diabetes Control and Management registry database in the year 2009. The four public health facilities were hospital with specialists (HS), hospital without specialists (HNS), health clinics with family medicine specialists (CS) and health clinic without doctors (CND). Descriptive analyses were used to examine age, duration of diseases, intervals from the onset of diabetes to co-morbidities (hypertension and dyslipidaemia) and complication of T2D patients at the four public health facilities.
Patients were significantly older in HS. Patients with T2D at HS had significantly longer duration of diabetes, hypertension and dyslipidaemia. Health clinics, both the CS and the CND, were seeing T2D patients with shorter duration of macrovascular and microvascular complications.
Public health clinics in this country managed T2D patients who were younger and at the early stage of diabetes, hypertension, dyslipidaemia and complications. Thus, primary care physicians are best positioned to provide early and intensive diabetes care for this group of T2D patients to prevent the development of diabetes-related complications.
我们对马来西亚四个不同公共卫生机构中2型糖尿病(T2D)患者的疾病概况进行了研究,以确定哪个机构最适合针对糖尿病相关并发症开展早期强化糖尿病护理。
本研究分析了2009年成人糖尿病控制与管理登记数据库中的57780例T2D患者。这四个公共卫生机构分别是有专科医生的医院(HS)、无专科医生的医院(HNS)、有家庭医学专科医生的健康诊所(CS)和无医生的健康诊所(CND)。采用描述性分析来研究四个公共卫生机构中T2D患者的年龄、病程、从糖尿病发病到合并症(高血压和血脂异常)的间隔时间以及并发症情况。
HS的患者年龄显著更大。HS的T2D患者糖尿病、高血压和血脂异常的病程显著更长。CS和CND这两个健康诊所接待的T2D患者大血管和微血管并发症的病程较短。
该国的公共卫生诊所诊治的T2D患者年龄较轻,且处于糖尿病、高血压、血脂异常及并发症的早期阶段。因此,初级保健医生最有条件为这群T2D患者提供早期强化糖尿病护理,以预防糖尿病相关并发症的发生。