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荷兰2型糖尿病初级护理中结直肠癌幸存者与非癌症患者的血糖控制:一项前瞻性队列研究。

Glycemic Control for Colorectal Cancer Survivors Compared to Those without Cancer in the Dutch Primary Care for Type 2 Diabetes: A Prospective Cohort Study.

作者信息

de Haan-Du Jing, Landman Gijs W D, Kleefstra Nanne, Schrijnders Dennis, Manders Marjolijn, Bos Amanda C R K, Tromp-van Driel Cathrien, Denig Petra, Groenier Klaas H, de Bock Geertruida H

机构信息

Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands.

Langerhans Medical Research Group, 7731 AT Ommen, The Netherlands.

出版信息

Cancers (Basel). 2021 Jun 2;13(11):2767. doi: 10.3390/cancers13112767.

Abstract

Cancer survivors with diabetes tend to have worse glycemic control after their cancer diagnosis, which may increase the risk of cardiovascular diseases. We aimed to investigate whether glycemic control differs between colorectal cancer (CRC) survivors and those without cancer, among patients with type 2 diabetes being treated in the Dutch primary care. The Zwolle Outpatient Diabetes project Integrating Available Care database was linked with the Dutch Cancer Registry ( = 71,648, 1998-2014). The cases were those with stage 0-III CRC, and the controls were those without cancer history. The primary and secondary outcomes were the probability of reaching the glycated hemoglobin (HbA1c) target and the mean of HbA1c during follow-up, respectively. Mixed linear modeling was applied, where the status of CRC was a time-varying variable. Among the 57,330 patients included, 705 developed CRC during follow-up. The mean probability of reaching the HbA1c target during follow-up was 73% versus 74% ( = 0.157) for CRC survivors versus those without cancer, respectively. The mean HbA1c was 51.1 versus 50.8 mmol/mol ( = 0.045) among CRC survivors versus those without cancer, respectively. We observed a clinically comparable glycemic control among the CRC survivors without cancer, indicating that glycemic control for CRC survivors can be delegated to primary care professionals.

摘要

癌症幸存者若患有糖尿病,在癌症确诊后往往血糖控制更差,这可能会增加心血管疾病的风险。我们旨在调查在荷兰初级医疗中接受治疗的2型糖尿病患者中,结直肠癌(CRC)幸存者与无癌症者之间的血糖控制情况是否存在差异。将兹沃勒门诊糖尿病项目整合可用护理数据库与荷兰癌症登记处相链接(n = 71,648,1998 - 2014年)。病例为0 - III期CRC患者,对照为无癌症病史者。主要和次要结局分别是达到糖化血红蛋白(HbA1c)目标的概率以及随访期间HbA1c的平均值。应用混合线性模型,其中CRC状态为随时间变化的变量。在纳入的57,330名患者中,705名在随访期间患CRC。随访期间达到HbA1c目标的平均概率,CRC幸存者为73%,无癌症者为74%(P = 0.157)。CRC幸存者与无癌症者的平均HbA1c分别为51.1 mmol/mol和50.8 mmol/mol(P = 0.045)。我们观察到CRC幸存者与无癌症者在临床上血糖控制相当,这表明CRC幸存者的血糖控制可交由初级医疗专业人员负责。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd0b/8199666/04514d3d74b0/cancers-13-02767-g001.jpg

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