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基层医疗中2型糖尿病患者的自我报告口腔健康与生活质量:一项多中心横断面研究。

Self-reported oral health and quality of life in patients with type 2 diabetes mellitus in primary care: a multi-center cross-sectional study.

作者信息

Verhulst Martijn Jl, Teeuw Wijnand J, Gerdes Victor Ea, Loos Bruno G

机构信息

Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University, Amsterdam, The Netherlands.

Department of Vascular Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands.

出版信息

Diabetes Metab Syndr Obes. 2019 Jun 18;12:883-899. doi: 10.2147/DMSO.S207087. eCollection 2019.

Abstract

Guidelines for primary diabetes care recommend to pay attention to oral health in patients with diabetes mellitus type 2 (T2DM). However, research about dental care utilization and the extent of problems regarding oral health in these patients is limited. To assess self-reported oral health, general health-related quality of life (QoL) and oral health-related QoL in patients with T2DM who regularly attend a family physician office. Family physician offices were recruited in the area of Amsterdam, the Netherlands, as part of a cluster-randomized controlled trial. At these offices, patients with T2DM were included by family physicians and/or nurse practitioners. Patient data on general characteristics, self-reported oral health (including periodontitis), general health-related QoL (SF-36) and oral health-related QoL (OHIP-NL14) were collected. Twenty-four family physician offices participated, who enrolled 764 patients with T2DM (mean age: 65.9±10.7 years, 56% male, 16% smoker). Almost 11% of the patients were metabolically poorly controlled (HbA1c >63 mmol/mol), 39% were obese (body mass index≥30 kg/m), 37% had hypertension (systolic blood pressure ≥140 mmHg) and 44% had dyslipidemia (LDL-cholesterol >2.5 mmol/L). About a quarter (24%) reported not to visit a dentist regularly and 30% did not have dental insurance coverage. Furthermore, 16% of the patients were edentulous and having full dental prostheses, while 29% had a partial dental prosthesis. Pain in the mouth, dry mouth and bad breath were reported by 15%, 37% and 12% of the patients, respectively. Almost 70% suffered from periodontitis. Oral health-related QoL was impaired in 19% of the patients, and those subjects also had worse general health-related QoL. Almost a quarter of patients with T2DM at Dutch family physician offices does not visit the dentist regularly. The estimated prevalence of periodontitis is particularly high, but other oral health complaints and impaired oral health-related QoL are also relatively common.

摘要

原发性糖尿病护理指南建议关注2型糖尿病(T2DM)患者的口腔健康。然而,关于这些患者的牙科护理利用情况以及口腔健康问题程度的研究有限。为了评估定期前往家庭医生诊所就诊的T2DM患者自我报告的口腔健康、总体健康相关生活质量(QoL)和口腔健康相关生活质量。作为一项整群随机对照试验的一部分,在荷兰阿姆斯特丹地区招募了家庭医生诊所。在这些诊所,家庭医生和/或执业护士纳入了T2DM患者。收集了患者的一般特征、自我报告的口腔健康(包括牙周炎)、总体健康相关生活质量(SF-36)和口腔健康相关生活质量(OHIP-NL14)的数据。24个家庭医生诊所参与其中,共纳入764例T2DM患者(平均年龄:65.9±10.7岁,56%为男性,16%为吸烟者)。近11%的患者代谢控制不佳(糖化血红蛋白>63 mmol/mol),39%为肥胖(体重指数≥30 kg/m²),37%患有高血压(收缩压≥140 mmHg),44%患有血脂异常(低密度脂蛋白胆固醇>2.5 mmol/L)。约四分之一(24%)报告不定期看牙医,30%没有牙科保险。此外,16%的患者无牙并佩戴全口假牙,29%佩戴局部假牙。分别有15%、37%和12%的患者报告有口腔疼痛、口干和口臭。近70%患有牙周炎。19%的患者口腔健康相关生活质量受损,这些患者的总体健康相关生活质量也较差。在荷兰家庭医生诊所,近四分之一的T2DM患者不定期看牙医。牙周炎的估计患病率特别高,但其他口腔健康问题和口腔健康相关生活质量受损也相对常见。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b401/6590843/ca3a08f982a4/DMSO-12-883-g0001.jpg

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