Department of Health Sciences, Universidad de Especialidades Espíritu Santo, Guayaquil 090101, Ecuador.
School of Medicine, Yale University, New Haven, CT 06510, USA.
Medicina (Kaunas). 2022 Mar 4;58(3):380. doi: 10.3390/medicina58030380.
Diabetes mellitus affects 422 million people around the world, positioning it as a major health problem. According to the WHO(World Health Organization), 90% corresponds to type 2. The shared-decision making (SDM) is a method used to facilitate patient control, medication, maintenance, and assessment of health status according to their priorities and preferences. With the application of SDM in patients with diabetes, it is expected there will be an increase in treatment adherence and a reduction in HbA1c levels. The aim of this study is to determine the predictors of the change in HbA1c. A sample of 76 participants attending as endocrinology outpatients was obtained. Data collected within the sample included: sex, age, educational level, body mass index, and the level of SDM using the SDMQ-9. In addition, HbA1c levels were measured twice: at baseline and three months after the first measurement. The linear regression indicates that the level of SDM is a significant predictor of the change in HbA1c, specifically in men. However, the direction of the relationship was a somewhat opposite trend than we expected. Higher levels of SDM imply an increase in HbA1c rather than a reduction. : Contrary to the literature, our results shows that elevated levels of perceived SDM may be associated with worse diabetic control. However, more investigation is needed as these results are not generalizable, due to the specific population used and the sample size. Furthermore, to better understand the effect of SDM on the change in HbA1c in patients with poorly controlled diabetes.
糖尿病影响着全球 4.22 亿人，使其成为一个主要的健康问题。根据世界卫生组织（WHO）的数据，90%的病例为 2 型糖尿病。共同决策（SDM）是一种用于根据患者的优先事项和偏好来促进患者控制、用药、维持和评估健康状况的方法。在糖尿病患者中应用 SDM，预计会增加治疗依从性并降低 HbA1c 水平。本研究旨在确定 HbA1c 变化的预测因素。研究人员获得了 76 名参加内分泌科门诊的参与者的样本。样本中收集的数据包括：性别、年龄、教育水平、体重指数以及使用 SDMQ-9 进行的 SDM 水平。此外，还测量了两次 HbA1c 水平：基线时和第一次测量后三个月。线性回归表明，SDM 水平是 HbA1c 变化的一个重要预测因素，特别是在男性中。然而，关系的方向与我们预期的有些相反。SDM 水平越高，HbA1c 反而会升高而不是降低。与文献相反，我们的结果表明，感知到的 SDM 水平升高可能与糖尿病控制恶化有关。然而，由于使用的特定人群和样本量，这些结果不是普遍适用的，因此需要进一步研究。此外，为了更好地理解 SDM 对控制不佳的糖尿病患者 HbA1c 变化的影响。
