Janghorbani Mohsen, Papi Bahman, Amini Masoud
School of Public Health, Isfahan University of Medical Sciences Isfahan, Iran ; Isfahan Endocrine and Metabolism Research Center, Isfahan University of Medical Sciences Isfahan, Iran.
School of Public Health, Isfahan University of Medical Sciences Isfahan, Iran.
J Diabetes Investig. 2015 Nov;6(6):716-25. doi: 10.1111/jdi.12349. Epub 2015 Apr 17.
AIMS/INTRODUCTION: To estimate the prevalence of meeting American Diabetes Association clinical practice recommendations for hemoglobin A1c (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) among Iranian type 2 diabetes clinic attendees, and to identify the factors associated with therapeutic target achievement.
A total of 2,640 patients with type 2 diabetes (944 men and 1,696 women) from Isfahan Endocrine and Metabolism Research Center outpatient clinics, Iran, were examined. The main outcome measures were HbA1c, BP and LDLC, in accordance with the American Diabetes Association recommendations. The mean (standard deviation) age of participants was 49.6 years (9.3 years) with a mean (standard deviation) duration of diabetes of 5.0 years (4.9 years) at initial registration.
The percentages of patients who had HbA1c <7%, BP <140/90 mmHg and LDLC <100 mg/dL was 37.4% (95% confidence interval [CI] 35.6-39.3), 35.3% (95% CI 33.5-37.3) and 48.9% (95% CI 47.0-50.8), respectively. The proportion of patients meeting all three goals was 7.7% (95% CI 6.7-8.8). Lower BP, cholesterol level and higher education at registration, and higher follow up but lower number of follow-up visits affected achievement of all three goals.
The present study highlights that a substantial proportion of Iranian type 2 diabetes clinic attendees did not meet the American Diabetes Association clinical practice recommendations, and shows the difficult challenges physicians face when treating patients with type 2 diabetes.
目的/引言:评估伊朗2型糖尿病门诊患者中符合美国糖尿病协会血红蛋白A1c(HbA1c)、血压(BP)和低密度脂蛋白胆固醇(LDLC)临床实践建议的比例,并确定与治疗目标达成相关的因素。
对来自伊朗伊斯法罕内分泌与代谢研究中心门诊的2640例2型糖尿病患者(944例男性和1696例女性)进行了检查。主要观察指标依据美国糖尿病协会的建议,包括HbA1c、BP和LDLC。参与者的平均(标准差)年龄为49.6岁(9.3岁),初次登记时糖尿病的平均(标准差)病程为5.0年(4.9年)。
HbA1c<7%、BP<140/90 mmHg和LDLC<100 mg/dL的患者比例分别为37.4%(95%置信区间[CI] 35.6 - 39.3)、35.3%(95% CI 33.5 - 37.3)和48.9%(95% CI 47.0 - 50.8)。达到所有三个目标的患者比例为7.7%(95% CI 6.7 - 8.8)。登记时较低的血压、胆固醇水平和较高的教育程度,以及较高的随访率但较少的随访次数影响了所有三个目标的达成。
本研究强调,相当一部分伊朗2型糖尿病门诊患者未达到美国糖尿病协会的临床实践建议,显示出医生在治疗2型糖尿病患者时面临的艰巨挑战。