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系统评价注册营养师在初级保健环境中对 2 型糖尿病患者进行糖尿病自我管理教育的干预频率。

Systematic Review of the Frequency of Registered Dietitian-Nutritionist Intervention in the Primary Care Setting for Diabetes Self-Management Education for Patients with Type II Diabetes.

机构信息

Department of Internal Medicine, Virginia Commonwealth University Medical Center, Richmond, VA, United States.

出版信息

Curr Diabetes Rev. 2023;19(8):e210722206962. doi: 10.2174/1573399819666220721113103.

Abstract

PURPOSE

The purpose of this systematic review is to discuss the ideal frequency of Registered Dietitian-Nutritionist (RDN) contact required to improve glycemic control in patients with type 2 diabetes in the primary care setting.

METHODS

Researchers completed a literature search between April 1 and June 30, 2020. Researchers identified 184 studies and included seven studies for full-text analysis. Eligible studies were required to occur in a primary care setting, use A1C as an outcome measure, and use some form of education or contact with an RDN. Study quality was assessed using the NIH Study Quality Assessment Tool.

RESULTS

Compared to the usual care group of each study, increased contact with an RDN improved A1C lowering regardless of frequency (round-the-clock, monthly, biannually). The largest decreases occurred in the round-the-clockand quarterly touch groups. Studies varied in modality (inperson, telehealth, etc.) and type of intervention. The participants had A1Cs between 8.07% and 10.25% before intervention. With RDN contact of any frequency between provider visits and participants saw A1Cs decreased between 0.66% and 2.2%.

CONCLUSION

Greater glycemic control in patients with type 2 diabetes in the primary care environment is linked to more frequent RDN contact than that advised by the American Diabetes Association Standards of Care.

摘要

目的

本系统评价旨在讨论在初级保健环境中,为改善 2 型糖尿病患者的血糖控制,注册营养师(RDN)所需的理想联系频率。

方法

研究人员于 2020 年 4 月 1 日至 6 月 30 日完成了文献检索。研究人员确定了 184 项研究,并对其中 7 项进行了全文分析。合格的研究需要在初级保健环境中进行,使用 A1C 作为结局指标,并使用某种形式的教育或与 RDN 的联系。研究质量使用 NIH 研究质量评估工具进行评估。

结果

与每项研究的常规护理组相比,增加与 RDN 的接触无论频率如何(全天候、每月、每两个月)都能改善 A1C 降低。在全天候和每季度接触组中,降幅最大。研究在模式(面对面、远程医疗等)和干预类型上存在差异。参与者的 A1C 在干预前介于 8.07%和 10.25%之间。在每次就诊期间和之后与 RDN 的任何频率接触,参与者的 A1C 都降低了 0.66%至 2.2%。

结论

与美国糖尿病协会护理标准建议的相比,在初级保健环境中,2 型糖尿病患者的血糖控制更好与更频繁的 RDN 接触有关。

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