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孟加拉国一家三级医院糖尿病患者中严重低血糖对生活质量的影响

The Burden of Severe Hypoglycemia on Quality of Life among Diabetes Mellitus Patients in a Tertiary Level Hospital of Bangladesh.

作者信息

Ahammed Afsar, Pathan Faruque, Afsana Faria, Ahammed Imran, Mir Ahmed Salam, Yusuf Abdullah

机构信息

Department of Physiotherapy, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh.

Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation in Diabetes Endocrine and Metabolic Disorders, Dhaka, Bangladesh.

出版信息

Indian J Endocrinol Metab. 2018 Jul-Aug;22(4):499-504. doi: 10.4103/ijem.IJEM_338_17.

Abstract

OBJECTIVE

This study aimed to determine the impact of hypoglycemia on health-related quality of life from a patient perspective.

MATERIALS AND METHODS

A cross-sectional study was conducted in 164 type 2 diabetes patients admitted due to severe hypoglycemia from August 2015 to October 2016 at Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, in Dhaka. Impact of severe hypoglycemia on health-related quality of life in diabetic patients was evaluated using the disease-specific questionnaire audit of diabetes-dependent quality of life-19 (ADDQOL-19).

RESULTS

The median ADDQOL score was calculated at -3.31. Totally, 88 (53.7%) patients reported an ADDQOL score of - 3.31 or more, and 76 (46.3%) patients had an ADDQOL score of less than -3.31 (lower quality of life [QoL]). After considering weighting, "Freedom to eat" (mean Weighted Impact Score-6.32 ± 1.94) was the most and "Holidays" (mean Weighted Impact Score-0.96 ± 0.19) was the least affected QoL domains, respectively. In multivariate logistic regression analysis, severe hypoglycemia impact on ADDQOL was related with age (odds ratio [OR] 0.932, 95% confidence intervals [CIs] 0.897-0.969, < 0.001), sex (OR 0.088, 95% CIs 0.023-0.338, < 0.001), glycated hemoglobin (%) (OR 0.613, 95% CIs 0.422-0.890, = 0.010), and marital status (OR 9.264, 95% CIs 2.467-34.790, = 0.001).

CONCLUSIONS

The results of this analysis suggest hypoglycemia impacts heavily on the well-being and quality of life of people with diabetes, and every effort should be made to minimize hypoglycemia while aiming for good glycemic control.

摘要

目的

本研究旨在从患者角度确定低血糖对健康相关生活质量的影响。

材料与方法

于2015年8月至2016年10月在达卡的孟加拉国糖尿病、内分泌和代谢紊乱研究与康复研究所,对164例因严重低血糖入院的2型糖尿病患者进行了一项横断面研究。使用特定疾病问卷“糖尿病相关生活质量-19”(ADDQOL-19)评估严重低血糖对糖尿病患者健康相关生活质量的影响。

结果

ADDQOL得分中位数为-3.31。共有88例(53.7%)患者报告ADDQOL得分为-3.31或更高,76例(46.3%)患者的ADDQOL得分低于-3.31(生活质量较低)。在考虑加权后,“饮食自由”(平均加权影响得分-6.32±1.94)是受影响最大的生活质量领域,“节假日”(平均加权影响得分-0.96±0.19)是受影响最小的生活质量领域。在多因素逻辑回归分析中,严重低血糖对ADDQOL的影响与年龄(比值比[OR]0.932,95%置信区间[CI]0.897 - 0.969,P<0.001)、性别(OR 0.088,95%CI 0.023 - 0.338,P<0.001)、糖化血红蛋白(%)(OR 0.613,95%CI 0.422 - 0.890,P = 0.010)和婚姻状况(OR 9.264,95%CI 2.467 - 34.790,P = 0.001)有关。

结论

该分析结果表明低血糖对糖尿病患者的幸福感和生活质量有严重影响,在努力实现良好血糖控制的同时,应尽一切努力将低血糖降至最低。

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