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全球真实世界临床实践中 1 型糖尿病成人患者报告结局:SAGE 研究。

Patient-reported outcomes in adults with type 1 diabetes in global real-world clinical practice: The SAGE study.

机构信息

Diabetes Department, Royal Derby Hospital, Derby, UK.

University of Nottingham, Nottingham, UK.

出版信息

Diabetes Obes Metab. 2021 Aug;23(8):1892-1901. doi: 10.1111/dom.14416. Epub 2021 Jun 14.

DOI:10.1111/dom.14416
PMID:33914401
Abstract

AIMS

To conduct a secondary analysis of the SAGE study to evaluate the association between glycaemic control and patient-reported outcomes (PROs), in adults with type 1 diabetes (T1DM) across different age groups and regions.

MATERIALS AND METHODS

SAGE was a multinational, cross-sectional, observational study in adults with T1DM. Data were collected at a single visit, analysed according to predefined age groups (26-44, 45-64, and ≥65 years), and reported across different regions. PRO questionnaires were applied to assess hypoglycaemia fear (Hypoglycemia Fear Survey-II), diabetes-related distress (Problem Areas In Diabetes questionnaire), insulin treatment satisfaction (Insulin Treatment Satisfaction Questionnaire), and diabetes-specific quality of life (QoL; Audit of Diabetes-Dependent Quality of Life). Multivariable analysis was performed to evaluate the relationship between glycated haemoglobin (HbA1c) target achievement (<7% and individualised targets) with PRO scores.

RESULTS

The PRO scores showed relatively low levels of diabetes-related emotional distress and fear of hypoglycaemia, moderate to high treatment satisfaction, and low diabetes-related impact on QoL. Results were generally comparable across age groups with some regional variability. Achievement of the HbA1c <7% target was associated with less worry about hypoglycaemia, lower diabetes-related emotional distress, higher insulin treatment satisfaction, and higher QoL. Achievement of individualised HbA1c targets was associated with lower diabetes-related emotional distress and higher insulin treatment satisfaction.

CONCLUSIONS

Better glycaemic control was most closely associated with low emotional distress due to diabetes and high patient-reported insulin treatment satisfaction.

摘要

目的

对 SAGE 研究进行二次分析,评估血糖控制与患者报告的结局(PRO)之间的关系,纳入了来自不同年龄组和地区的 1 型糖尿病(T1DM)成人患者。

材料和方法

SAGE 是一项多中心、横断面、观察性研究,纳入了 T1DM 成年患者。数据在一次就诊时收集,根据预先设定的年龄组(26-44 岁、45-64 岁和≥65 岁)进行分析,并在不同地区进行报告。PRO 问卷用于评估低血糖恐惧(低血糖恐惧调查 II)、糖尿病相关困扰(糖尿病问题区域问卷)、胰岛素治疗满意度(胰岛素治疗满意度问卷)和糖尿病特异性生活质量(QoL;糖尿病依赖生活质量评估)。采用多变量分析评估糖化血红蛋白(HbA1c)目标达标(<7%和个体化目标)与 PRO 评分之间的关系。

结果

PRO 评分显示出相对较低的糖尿病相关情绪困扰和低血糖恐惧程度、中等至较高的治疗满意度,以及较低的糖尿病对 QoL 的影响。结果在不同年龄组之间基本一致,但存在一定的区域性差异。HbA1c<7%目标的达标与低血糖担忧减少、糖尿病相关情绪困扰降低、胰岛素治疗满意度提高和 QoL 升高相关。个体化 HbA1c 目标的达标与糖尿病相关情绪困扰降低和胰岛素治疗满意度提高相关。

结论

更好的血糖控制与因糖尿病引起的情绪困扰减轻和患者报告的胰岛素治疗满意度提高密切相关。

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