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不良自我护理行为及城市居民身份强烈预示埃塞俄比亚东部2型糖尿病患者的慢性并发症:一项基于医院的横断面研究

Poor Self-Care Practices and Being Urban Resident Strongly Predict Chronic Complications Among Patients with Type 2 Diabetes in Eastern Ethiopia: A Hospital-Based Cross-Sectional Study.

作者信息

Letta Shiferaw, Aga Fekadu, Yadeta Tesfaye Assebe, Geda Biftu, Dessie Yadeta

机构信息

School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.

School of Nursing and Midwifery, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.

出版信息

Diabetes Metab Syndr Obes. 2022 Jul 20;15:2095-2106. doi: 10.2147/DMSO.S368165. eCollection 2022.

Abstract

BACKGROUND

Diabetes, together with its complications, has a considerable negative influence on people's quality of life and healthcare delivery and raises diabetic mortality. However, there is limited information about the diabetes-associated chronic complications in the study setting. Therefore, this study aimed to determine the burden and factors related to the chronic complications among patients with type 2 diabetes (T2D) in Eastern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted among 879 patients with T2D at two public hospitals in Harar. The data were collected through interviews using a structured questionnaire. Data related to the diagnosis of chronic complications and biochemical tests were extracted from medical records. The outcome variable was the number of chronic complications that happened to the patients. A generalized Poisson regression model with robust variance estimation was used to investigate the association of independent variables with chronic complications. An adjusted prevalence ratio with a 95% CI was reported to show an association using a p-value ≤0.05.

RESULTS

One or more chronic complications were presented in 43% of T2D (95% CI: 39.65, 46.19). Macrovascular and microvascular complications were found in 27.6% and 23.5% of patients, respectively. Urban residence (APR = 2.64; 95% CI: 1.54, 4.54), low wealth status (APR = 1.80; 95% CI: 1.17, 2.76), diabetes duration ≥5 years (APR = 1.46; 95% CI: 1.05, 2.01), hypertriglyceridemia (APR = 1.48; 95% CI: 1.07, 2.09) and poor self-care practices (APR = 1.62; 95% CI: 1.18, 2.23) were factors significantly associated with the chronic complications.

CONCLUSION

The burden of chronic complications was high, with nearly half of T2D patients experiencing one or more chronic complications. Almost one in ten patients suffered from multiple chronic complications. The complications were mainly influenced by being urban resident, low wealth status, and poor self-care practices. Therefore, health care providers need to educate patients and promote self-care practices and healthy lifestyles to achieve treatment goals and lower the risk of chronic complications.

摘要

背景

糖尿病及其并发症对人们的生活质量和医疗服务产生了相当大的负面影响,并增加了糖尿病死亡率。然而,在该研究环境中,关于糖尿病相关慢性并发症的信息有限。因此,本研究旨在确定埃塞俄比亚东部2型糖尿病(T2D)患者慢性并发症的负担及相关因素。

方法

在哈勒尔的两家公立医院对879例T2D患者进行了一项基于医院的横断面研究。通过使用结构化问卷进行访谈收集数据。从医疗记录中提取与慢性并发症诊断和生化检查相关的数据。结果变量是患者发生的慢性并发症数量。使用具有稳健方差估计的广义泊松回归模型来研究自变量与慢性并发症之间的关联。报告了调整后的患病率比及95%置信区间,以显示p值≤0.05时的关联。

结果

43%的T2D患者出现了一种或多种慢性并发症(95%置信区间:39.65,46.19)。大血管和微血管并发症分别在27.6%和23.5%的患者中被发现。城市居住(调整患病率比=2.64;95%置信区间:1.54,4.54)、低财富状况(调整患病率比=1.80;95%置信区间:1.17,2.76)、糖尿病病程≥5年(调整患病率比=1.46;95%置信区间:1.05,2.01)、高甘油三酯血症(调整患病率比=1.48;95%置信区间:1.07,2.09)和自我护理习惯差(调整患病率比=1.62;95%置信区间:1.18,2.23)是与慢性并发症显著相关的因素。

结论

慢性并发症的负担很高,近一半的T2D患者经历了一种或多种慢性并发症。近十分之一的患者患有多种慢性并发症。这些并发症主要受城市居住、低财富状况和自我护理习惯差的影响。因此,医疗保健提供者需要教育患者并促进自我护理习惯和健康的生活方式,以实现治疗目标并降低慢性并发症的风险。

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