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体重减轻与血糖结果之间的关联:糖尿病管理远程患者监测项目分析

Association Between Weight Loss and Glycemic Outcomes: A Analysis of a Remote Patient Monitoring Program for Diabetes Management.

作者信息

Michaud Tzeyu L, Siahpush Mohammad, Estabrooks Paul, Schwab Robert J, LeVan Tricia D, Grimm Brandon, Ramos Athena K, Johansson Patrik, Scoggins Dylan, Su Dejun

机构信息

Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.

Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA.

出版信息

Telemed J E Health. 2020 May;26(5):621-628. doi: 10.1089/tmj.2019.0030. Epub 2019 Aug 14.

Abstract

: Evidence-based guidelines for the management of type 2 diabetes (T2D) consist of blood glucose monitoring, medication adherence, and lifestyle modifications that may particularly benefit from reminders, consultation, education, and behavioral reinforcements through remote patient monitoring (RPM). : To identify predictors of weight loss and to examine the association between weight loss and hemoglobin A1C (HbA1C) outcomes for T2D patients who were enrolled in an RPM program for diabetes management. : The study applied logistic and ordinary least-squares regression models to examine the relationship between baseline characteristics and the likelihood of weight loss during the RPM, and how the magnitude of weight loss was related to changes in HbA1C outcomes for 1,103 T2D patients who went through 3 months of RPM from 2014 to 2017. : Older patients were 3% more likely to have weight loss (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05), whereas patients with higher baseline HbA1C had 9% reduced odds (OR, 0.91; 95% CI, 0.85-0.97) of experiencing weight loss. For every pound of weight lost, there was a 0.02-point (95% CI, 0.01-0.03) reduction on the HbA1C measured at the end of the RPM. Moreover, compared with those who had weight loss of ≤3%, participants who had lost 5-7%, or >7% of their baseline weight had a 0.37- and 0.58-point reduction in HbA1C, respectively. : This study revealed a notable relationship between weight loss and positive HbA1C outcomes for T2D patients in an RPM-facilitated diabetes management program, which pointed to the potential of integrating evidence-based lifestyle modification programs into future telemedicine programs to improve diabetes management outcomes.

摘要

2型糖尿病(T2D)管理的循证指南包括血糖监测、药物依从性和生活方式改变,通过远程患者监测(RPM)进行提醒、咨询、教育和行为强化可能会使其特别受益。

为了确定体重减轻的预测因素,并检查参加RPM糖尿病管理项目的T2D患者体重减轻与糖化血红蛋白(HbA1C)结果之间的关联。

该研究应用逻辑回归和普通最小二乘回归模型,研究了1103名在2014年至2017年期间接受了3个月RPM的T2D患者的基线特征与RPM期间体重减轻可能性之间的关系,以及体重减轻幅度与HbA1C结果变化之间的关系。

老年患者体重减轻的可能性高3%(优势比[OR],1.03;95%置信区间[CI],1.02 - 1.05),而基线HbA1C较高的患者体重减轻的几率降低9%(OR,0.91;95%CI,0.85 - 0.97)。每减轻一磅体重,RPM结束时测量的HbA1C就会降低0.02个点(95%CI,0.01 - 0.03)。此外,与体重减轻≤3%的参与者相比,体重减轻5 - 7%或>7%的参与者的HbA1C分别降低了0.37和0.58个点。

这项研究揭示了在RPM促进的糖尿病管理项目中,T2D患者体重减轻与HbA1C阳性结果之间的显著关系,这表明将循证生活方式改变项目纳入未来远程医疗项目以改善糖尿病管理结果的潜力。

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