Moradi Ghobad, Shokri Azad, Mohamadi-Bolbanabad Amjad, Zareie Bushra, Piroozi Bakhtiar
Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran.
Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
Heliyon. 2021 Mar 17;7(3):e06485. doi: 10.1016/j.heliyon.2021.e06485. eCollection 2021 Mar.
The present study was conducted to evaluate the quality of care for type2 diabetic patients based on the HbA1c in Iran.
This cross-sectional study was conducted in 2019 among patients with type 2 diabetes in Iran. The data were collected through a three-part questionnaire including demographic information, disease-related records, and HbA1C status of patients. Multiple logistic regression was used to investigate the relationship between the outcome variable (HbA1c status) and the independent variables in Stata 12.
The mean HBA1c was 8.01 ± 1.76% among 1,198 diabetic patients, and more than 66% of them had HBA1c above 7%, i.e. they had uncontrolled blood sugar levels. HBA1c has the highest average among people with more than 10 years of diabetes (8.47 ± 1.77%), self-employed people (8.36 ± 1.94%), illiterate people or those with elementary education (8.13 ± 1.76%) and people with poor economic status (8.12 ± 1.79%). Also, in the final model, people with more than 10 years of disease history had the highest prevalence of HBA1C > 7 with a chance ratio of 3.28 (P < 0.001, 95%CI: 2.37-4.53) and followed by illiterate people or those with elementary education with a chance ratio of 1.6 (P = 0.020, 95%CI: 1.08-2.39) compared to those with high school diploma or academic education.
The prevalence of adverse HBA1c in 66% of the studied subjects indicates an inappropriate status of diabetes control in Iran. This indicates the poor quality of services provided to the diabetics. This is a warning sign and requires appropriate interventions to improve the quality of services provided to diabetic patients.
本研究旨在基于糖化血红蛋白（HbA1c）评估伊朗2型糖尿病患者的护理质量。
这项横断面研究于2019年在伊朗的2型糖尿病患者中进行。数据通过一份包含人口统计学信息、疾病相关记录以及患者HbA1C状况的三部分问卷收集。在Stata 12软件中使用多元逻辑回归来研究结果变量（HbA1c状况）与自变量之间的关系。
在1198名糖尿病患者中，平均糖化血红蛋白（HBA1c）为8.01±1.76%，其中超过66%的患者HBA1c高于7%，即他们的血糖水平未得到控制。在糖尿病病程超过10年的人群（8.47±1.77%）、个体经营者（8.36±1.94%）、文盲或小学文化程度的人群（8.13±1.76%）以及经济状况较差的人群（8.12±1.79%）中，HBA1c的平均值最高。此外，在最终模型中，疾病史超过10年的人群HBA1C>7的患病率最高，机会比为3.28（P<0.001, 95%CI: 2.37 - 4.53），其次是文盲或小学文化程度人群，机会比为1.6（P = 0.020, 95%CI: 1.08 - 2.39）, 而高中文凭或接受过学术教育人群的情况与之相比则较低。
66%研究对象中不良HBA1c的患病率表明伊朗糖尿病控制状况不佳。这表明为糖尿病患者提供的服务质量较差。这是一个警示信号，并需要采取适当干预措施来提高为糖尿病患者提供服务质量。
