College of Nursing, Creighton University, Omaha, Nebraska.
School of Pharmacy and Health Professions, Department of Pharmacy Practice, Creighton University, Omaha, Nebraska.
Diabetes Educ. 2019 Jun;45(3):295-301. doi: 10.1177/0145721719843680. Epub 2019 Apr 13.
The purpose of this study was to explore diabetes in adults experiencing homelessness by evaluating diabetes risk, A1C measurement, and achievement of the goals of the American Diabetes Association (ADA) Standards of Medical Care in Diabetes.
Project Homeless Connect Omaha is a 1-day health and social services event for adults who are homeless. The event seeks to meet immediate needs, identify potential future needs, and provide a connection with community resources for further follow-up for these adults. Health professions students and faculty from the university where the event is held volunteer their time to provide these services. Risk assessment for type 2 diabetes, A1C measurement, and evaluation of the ADA Standards of Medical Care were available for participants of this event.
Of the 478 participants who completed a risk assessment for diabetes, 91 underwent rapid A1C testing. Four participants at the diabetes station (4%) were newly identified as having diabetes with elevated A1C, and 32% of the participants had elevated A1C levels demonstrating prediabetes. Twelve individuals reported being previously diagnosed with diabetes, and of those, 50% had A1C levels between 7.3% and >13% (56 to 119 mmol/mol). Participants whose A1Cs classified them as having prediabetes or diabetes (n = 40) completed an evaluation of standards of medical care goals. Participants identified eye, foot, and dental examinations; lipid management; and urine protein screening as some of the areas in which the standards were not yet achieved.
Adults experiencing homelessness have a significant need for diabetes screening and management. Diabetes educators can provide education to equip adults with the ability to effectively manage their illness and prevent complications.
本研究旨在通过评估糖尿病风险、糖化血红蛋白（A1C）检测以及美国糖尿病协会（ADA）《糖尿病诊疗标准》目标的达标情况，来探讨无家可归的成年人中的糖尿病问题。
“奥马哈无家可归者连接项目”是一项针对无家可归成年人的为期 1 天的健康和社会服务活动。该活动旨在满足当前需求，发现潜在的未来需求，并为这些成年人提供与社区资源的联系，以进行进一步的后续跟进。举办该活动的大学的卫生专业学生和教师自愿提供这些服务。该活动为参与者提供了 2 型糖尿病风险评估、A1C 检测以及 ADA《糖尿病诊疗标准》评估。
在完成糖尿病风险评估的 478 名参与者中，91 人接受了快速 A1C 检测。在糖尿病检测站，有 4 名参与者（4%）新确诊为糖尿病，且 A1C 升高，32%的参与者 A1C 水平升高，表明存在前驱糖尿病。有 12 人报告曾被诊断患有糖尿病，其中 50%的人 A1C 水平在 7.3%至>13%（56 至 119mmol/mol）之间。A1C 检测结果提示处于前驱糖尿病或糖尿病的 40 名参与者完成了对医疗护理标准目标的评估。参与者认为，眼科、足部和牙科检查、血脂管理以及尿蛋白筛查是尚未达到标准的一些领域。
无家可归的成年人对糖尿病筛查和管理有巨大需求。糖尿病教育者可以提供教育，使成年人具备有效管理疾病和预防并发症的能力。
