Department of Food Science and Human Nutrition, Michigan State University , East Lansing, Michigan, USA.
Department of Human Nutrition and Health, Lilongwe University of Agriculture and Natural Resources (LUANAR) , Lilongwe, Malawi.
Soc Work Public Health. 2020 Jul 1;35(6):380-391. doi: 10.1080/19371918.2020.1785367. Epub 2020 Jul 7.
We assessed glycemic status and associations with socio-demographic, biomedical, anthropometric, and physical activity (PA) levels among adults with type 2 diabetes mellitus (T2DM) (n = 428; urban n = 288; semi-urban n = 140) using a cross-sectional study. Multivariate linear regression was used to determine factors associated with glycosylated hemoglobin (A1C) . A1C was clinically elevated ≥8% for 60.3% of the participants. Overall, age and PA levels showed a negative association with A1C, and positively with underweight status, duration of diabetes, and participants' view of fluctuating/unstable blood glucose and blood glucose not improved compared to first diagnosed. A significant negative association with A1C was shown with PA levels and additional blood glucose monitoring (BGM) beyond that received at the public clinic in the urban area. Whilst, in the semi-urban area, there was a significant positive association with A1C with regards to duration of diabetes and insulin regimen. Determinants of A1C in this target group are multifactorial, therefore, interventions aiming to improve diabetes clinical outcomes are needed to reduce the likelihood of serious ramifications. Additionally, a team approach from healthcare professionals is needed in conjunction with active patient engagement as well as the development of more comprehensive diabetes care guidelines and policies.
我们评估了 428 例 2 型糖尿病患者（其中城市患者 288 例，半城市患者 140 例）的血糖状况及其与社会人口统计学、生物医学、人体测量学和体力活动（PA）水平的关系。采用横断面研究。多变量线性回归用于确定与糖化血红蛋白（A1C）相关的因素。60.3%的参与者的 A1C 临床升高≥8%。总的来说，年龄和 PA 水平与 A1C 呈负相关，与体重不足状态、糖尿病病程以及参与者对血糖波动/不稳定和血糖改善不如首次诊断时的看法呈正相关。PA 水平与 A1C 呈显著负相关，且超出城市地区公共诊所接受的额外血糖监测（BGM）与 A1C 呈显著负相关。而在半城市地区，糖尿病病程和胰岛素治疗方案与 A1C 呈显著正相关。因此，需要针对该目标人群的多种因素进行干预，以降低严重后果的可能性。此外，还需要医疗保健专业人员的团队方法，以及积极的患者参与，以及制定更全面的糖尿病护理指南和政策。
