Alshareef Saad M, Alkhathlan Mujahed A, Alwabel Abdullah A, Al-Bawardi Abdulkarim A, Alqarni Abdulrahman H, Almuryidi Ali S, Altuwaim Ibrahim N, Alhabib Monther Khalid, Almuzaini Omar A, Alqahtani Turki S
Department of Medicine, College of Medicine, Al Imam Mohammad IBN Saud Islamic University, Riyadh, Saudi Arabia.
King Abdullah Scholarship Program, Ministry of Education, Riyadh, Saudi Arabia.
J Family Community Med. 2018 May-Aug;25(2):108-113. doi: 10.4103/jfcm.JFCM_126_17.
Despite the acknowledgment that the services of diabetes educator and dietician affect outcome, the level of utilization of these services in the Saudi Arabian public health-care system is not known. The aims of the study were to establish the percentage of patients with diabetes mellitus (DM) followed up by a diabetic educator and a dietician in a tertiary center in Saudi Arabia and associations between follow-up by a diabetic educator and a dietician and glycemic control.
This was a cross-sectional study of 490 diabetic patients who attended the diabetic outpatient clinic consecutively at a public health-care institution in Riyadh. Patients answered interview questions on clinicodemographic variables and diabetic educator or dietitian follow-up during their care. Hemoglobin A1C (HbA1C [%, mmol/mol]) and fasting blood glucose (mg/dL, mmol/L) levels were recorded.
The majority of patients were male (68.8%), Saudi (71%), married (91.6%), high school or college educated (55.5%), had type 2 DM (85.5%), and were taking oral hypoglycemics (57.3%). 69.0% and 19.8% of the patients had had at least some follow-up with a diabetic educator and dietician, respectively. HbA1C levels were significantly lower in patients who had had a follow-up with a dietitian (9.1 ± 4.5% [76 ± 26 mmol/mol] vs. 7.8 ± 2.2% [62 ± 13 mmol/mol]; unadjusted odds ratio [OR]: 0.80, 95% confidence intervals [CIs]: 0.71-0.89, P < 0.0001), including in multivariable analysis (adjusted OR: 0.84, 95% CIs: 0.72-0.99, P = 0.04). Follow-up with a diabetic educator was not associated with glycemic control.
Follow-up with a diabetic dietitian had the greatest impact on glycemic control in type 1 and type 2 DM patients. A review of the national standards of best practice of diabetes education and nutrition in Saudi Arabia is required to optimize the outcomes.
尽管人们承认糖尿病教育工作者和营养师的服务会影响治疗结果，但沙特阿拉伯公共卫生保健系统中这些服务的利用水平尚不清楚。本研究的目的是确定在沙特阿拉伯一家三级中心接受糖尿病教育工作者和营养师随访的糖尿病患者的百分比，以及糖尿病教育工作者和营养师的随访与血糖控制之间的关联。
这是一项对490例糖尿病患者的横断面研究，这些患者连续在利雅得的一家公共卫生保健机构的糖尿病门诊就诊。患者回答了关于临床人口统计学变量以及在其治疗期间接受糖尿病教育工作者或营养师随访的访谈问题。记录糖化血红蛋白（HbA1C[％，mmol/mol]）和空腹血糖（mg/dL，mmol/L）水平。
大多数患者为男性（68.8％），沙特人（71％），已婚（91.6％），具有高中或大学学历（55.5％），患有2型糖尿病（85.5％），并且正在服用口服降糖药（57.3％）。分别有69.0％和19.8％的患者至少接受过糖尿病教育工作者和营养师的一些随访。接受营养师随访的患者的HbA1C水平显著较低（9.1±4.5％[76±26 mmol/mol]对7.8±2.2％[62±13 mmol/mol]；未调整优势比[OR]：0.80，95％置信区间[CI]：0.71 - 0.89，P <0.0001），包括在多变量分析中（调整后OR：0.84，95％CI：0.72 - 0.99，P = 0.04）。接受糖尿病教育工作者的随访与血糖控制无关。
糖尿病营养师的随访对1型和2型糖尿病患者的血糖控制影响最大。需要对沙特阿拉伯糖尿病教育和营养最佳实践的国家标准进行审查，以优化治疗结果。
