Program in Health Services & Systems Research, Duke-NUS Medical School, Singapore, Singapore.
Department of Endocrinology, Singapore General Hospital, Singapore, Singapore.
PLoS One. 2021 Nov 8;16(11):e0259157. doi: 10.1371/journal.pone.0259157. eCollection 2021.
Asian populations are at high risk of diabetes and related vascular complications. We examined risk factor control, preventive care, and disparities in these trends among adults with diabetes in Singapore.
The sample included 209,930 adults with diabetes aged≥18 years from a multi-institutional SingHealth Diabetes Registry between 2013 and 2019 in Singapore. We performed logistic generalized estimating equations (GEEs) regression analysis and used linear mixed effect modeling to evaluate the temporal trends.
Between 2013 and 2019, the unadjusted control rates of glycated hemoglobin (4.8%, 95%CI (4.4 to 5.1) and low-density lipoprotein cholesterol (LDL-C) (11.5%, 95%CI (11.1 to 11.8)) improved, but blood pressure (BP) control worsened (systolic BP (SBP)/diastolic BP (DBP) <140/90 mmHg: -6.6%, 95%CI (-7.0 to -6.2)). These trends persisted after accounting for the demographics including age, gender, ethnicity, and housing type. The 10-year adjusted risk for coronary heart disease (CHD) (3.4%, 95% (3.3 to 3.5)) and stroke (10.4%, 95% CI (10.3 to 10.5)) increased. In 2019, the control rates of glycated hemoglobin, BP (SBP/DBP<140/90 mmHg), LDL-C, each, and all three risk factors together, accounted for 51.5%, 67.7%, 72.2%, and 24.4%, respectively.
Trends in risk factor control improved for glycated hemoglobin and LDL-C, but worsened for BP among diabetic adults in Singapore from 2013 to 2019. Control rates for all risk factors remain inadequate.
亚洲人群患糖尿病及相关血管并发症的风险较高。我们研究了新加坡成年糖尿病患者的危险因素控制、预防保健以及这些趋势的差异。
该研究样本来自 2013 年至 2019 年新加坡多家医疗机构的 SingHealth Diabetes Registry 中年龄≥18 岁的 209930 名成年糖尿病患者。我们采用逻辑广义估计方程（GEE）回归分析，并使用线性混合效应模型进行评估。
2013 年至 2019 年间，糖化血红蛋白（4.8%，95%CI（4.4 至 5.1）和低密度脂蛋白胆固醇（LDL-C）（11.5%，95%CI（11.1 至 11.8））的未调整控制率有所改善，但血压（BP）控制情况恶化（收缩压（SBP）/舒张压（DBP）<140/90mmHg：-6.6%，95%CI（-7.0 至-6.2））。这些趋势在考虑到年龄、性别、种族和住房类型等人口统计学因素后仍然存在。10 年冠心病（CHD）（3.4%，95%（3.3 至 3.5））和中风（10.4%，95%CI（10.3 至 10.5））的风险增加。2019 年，糖化血红蛋白、BP（SBP/DBP<140/90mmHg）、LDL-C、各单项危险因素和三项危险因素联合控制率分别为 51.5%、67.7%、72.2%和 24.4%。
2013 年至 2019 年间，新加坡成年糖尿病患者的糖化血红蛋白和 LDL-C 危险因素控制趋势有所改善，但 BP 控制情况恶化。所有危险因素的控制率仍然不足。
