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员工定期体检能否有助于发现血糖受损情况并提高患者对医嘱的遵从性?

Can Periodical Examinations of Employees Be Useful in Detection of Glycaemia Impairment and Improving Patients' Adherence to Medical Recommendations?

机构信息

Department of Occupational Diseases and Environmental Health, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland.

Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Łódź, Poland.

出版信息

Int J Environ Res Public Health. 2018 Mar 30;15(4):638. doi: 10.3390/ijerph15040638.

Abstract

Worldwide epidemiological data indicates insufficient diagnosis of diabetes as an increasing public health problem. In the search for solutions to this disadvantageous situation, occupational medicine health services seem to open up a unique opportunity to recognize some abnormalities in the early stages, especially among the asymptomatic working-age population. 316 workers underwent obligatory prophylactic examinations. In patients with twice assayed FGL ≥ 126 mg/dL (7.0 mmol/L) an additional intervention was implemented, including further diagnostic processes and therapy in General Practice (GP), followed by examination by an occupational health specialist within 3 months. The diagnosis of previously unknown diabetes was established among 2.5% of examined workers. All patients referred to the GP due to detected glycaemia impairment visited their doctor and finished the diagnostic process, took up therapy constrained by the occupational health physician to show the effects of intervention within 3 months. Prophylactic medical check-ups allow improved compliance and medical surveillance over glycaemia impairment in patients with prediabetes states, unknown diabetes or uncontrolled clinical course of diabetes. Considering fasting glucose level during mandatory prophylactic examination helps effective prevention of diabetes and its complications and thus provides public health system benefits.

摘要

全球流行病学数据表明,糖尿病的诊断不足,这是一个日益严重的公共卫生问题。在寻找解决这一不利局面的方法时,职业医学健康服务似乎为识别早期的一些异常情况提供了独特的机会,特别是在无症状的工作年龄段人群中。316 名工人接受了强制性的预防性检查。对于两次检测的 FGL 均≥126mg/dL(7.0mmol/L)的患者,实施了额外的干预措施,包括在全科医生(GP)中进行进一步的诊断过程和治疗,然后在 3 个月内由职业健康专家进行检查。在接受检查的工人中,有 2.5%被诊断为以前未知的糖尿病。由于发现血糖受损而被转介到 GP 的所有患者都去看了医生并完成了诊断过程,按照职业健康医生的规定进行了治疗,以在 3 个月内显示干预的效果。预防性体检有助于改善对糖尿病前期、未知糖尿病或糖尿病临床控制不佳患者的血糖异常的依从性和医疗监测。考虑在强制性预防性检查期间的空腹血糖水平有助于有效预防糖尿病及其并发症,从而为公共卫生系统带来益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8553/5923680/bce60e939514/ijerph-15-00638-g001.jpg

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