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描述 2 型糖尿病伴智力障碍成人的特征:病例发现研究的结果。

Characterizing adults with Type 2 diabetes mellitus and intellectual disability: outcomes of a case-finding study.

机构信息

Leeds Institute of Health Sciences, University of Leeds, Leeds.

Leeds Institute of Clinical Trials Research, University of Leeds, Leeds.

出版信息

Diabet Med. 2018 Mar;35(3):352-359. doi: 10.1111/dme.13510. Epub 2017 Oct 8.

Abstract

AIMS

To report the results of a case-finding study conducted during a feasibility trial of a supported self-management intervention for adults with mild to moderate intellectual disability and Type 2 diabetes mellitus, and to characterize the study sample in terms of diabetes control, health, and access to diabetes management services and support.

METHODS

We conducted a cross-sectional case-finding study in the UK (March 2013 to June 2015), which recruited participants mainly through primary care settings. Data were obtained from medical records and during home visits.

RESULTS

Of the 325 referrals, 147 eligible individuals participated. The participants' mean (sd) HbA concentration was 55 (15) mmol/mol [7.1 (1.4)%] and the mean (sd) BMI was 32.9 (7.9) kg/m , with 20% of participants having a BMI >40 kg/m . Self-reported frequency of physical activity was low and 79% of participants reported comorbidity, for example, cardiovascular disease, in addition to Type 2 diabetes. The majority of participants (88%) had a formal or informal supporter involved in their diabetes care, but level and consistency of support varied greatly. Post hoc exploratory analyses showed a significant association between BMI and self-reported mood, satisfaction with diet and weight.

CONCLUSIONS

We found high obesity and low physical activity levels in people with intellectual disability and Type 2 diabetes. Glycaemic control was no worse than in the general Type 2 diabetes population. Increased risk of morbidity in this population is less likely to be attributable to poor glycaemic control and is probably related, at least in part, to greater prevalence of obesity and inactivity. More research, focused on weight management and increasing activity in this population, is warranted.

摘要

目的

报告一项针对轻度至中度智力障碍和 2 型糖尿病成人的支持性自我管理干预措施可行性试验期间进行的病例发现研究结果,并根据糖尿病控制、健康以及获得糖尿病管理服务和支持的情况对研究样本进行特征描述。

方法

我们在英国进行了一项横断面病例发现研究(2013 年 3 月至 2015 年 6 月),主要通过基层医疗环境招募参与者。数据来自病历和家访。

结果

在 325 份转介中,有 147 名符合条件的个体参与了研究。参与者的平均(标准差)HbA 浓度为 55(15)mmol/mol [7.1(1.4)%],平均(标准差)BMI 为 32.9(7.9)kg/m²,20%的参与者 BMI 大于 40kg/m²。自我报告的身体活动频率较低,79%的参与者报告除 2 型糖尿病外还患有合并症,如心血管疾病。大多数参与者(88%)有正式或非正式的支持者参与他们的糖尿病护理,但支持的水平和一致性差异很大。事后探索性分析显示,BMI 与自我报告的情绪、饮食和体重满意度之间存在显著关联。

结论

我们发现智力障碍和 2 型糖尿病患者中肥胖和身体活动水平均较高。血糖控制并不比一般 2 型糖尿病患者差。该人群发病率增加不太可能归因于血糖控制不佳,可能与肥胖和缺乏活动的患病率较高有关,至少部分如此。需要针对该人群进行更多的研究,重点关注体重管理和增加活动量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3256/5836897/fbe0e6c1f285/DME-35-352-g001.jpg

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