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护士主导的方案对 2 型糖尿病患者血糖控制和微量白蛋白尿发展的影响。

Effect of the nurse-led program on blood glucose control and microalbuminuria development in type 2 diabetic populations.

机构信息

Department of Nursing, Hainan Western Central Hospital, Danzhou City, China.

Department of Internal Medicine, Hainan Western Central Hospital, Danzhou City, China.

出版信息

Medicine (Baltimore). 2022 Oct 14;101(41):e30693. doi: 10.1097/MD.0000000000030693.

Abstract

Current study was to evaluate whether the nurse-led program can improve glycated hemoglobin (HbA1c) control and reduce the incidence of microalbuminuria in type 2 diabetic mellitus (DM2) populations. A total of 150 DM2 subjects were randomly assigned to the usual-care group and nurse-led program group. Study endpoints included the HbA1c value, the percentage of subjects with HbA1c < 7.0%, the incidence of microalbuminuria, and the rate of adhering to antidiabetic drug at 6 months' follow-up. At baseline, there was no difference in fasting plasma glucose, HbA1c, proportion of subjects with HbA1c < 7.0%, the use of antidiabetic drug, and urinary albumin-creatinine ratio between these two groups. After 6 months' follow-up, the mean fasting plasma glucose and HbA1c were lower in the nurse-led program group, as was the proportion of subjects with HbA1c < 7.0%. The median urinary albumin-creatinine ratio and rate of incident microalbuminuria were also lower in the nurse-led program. The nurse-led program was associated with higher odds of achieving HbA1c < 7.0% and a lower incidence of microalbuminuria. After adjusted for covariates, the nurse-led program was still associated with 32% higher odds of achieving HbA1c < 7.0% and 11% lower incidence of microalbuminuria. These benefits were consistent by sex and age, while greater in those with obesity or hypertension (P interaction < .05). The nurse-led program is beneficial for blood glucose control and prevention of microalbuminuria.

摘要

本研究旨在评估护士主导的方案是否能改善糖化血红蛋白(HbA1c)的控制并降低 2 型糖尿病(DM2)人群微量白蛋白尿的发生率。共 150 例 DM2 患者被随机分配到常规护理组和护士主导的方案组。研究终点包括 HbA1c 值、HbA1c<7.0%的患者比例、微量白蛋白尿的发生率以及 6 个月随访时抗糖尿病药物的依从率。基线时,两组间空腹血糖、HbA1c、HbA1c<7.0%的患者比例、抗糖尿病药物的使用以及尿白蛋白肌酐比值均无差异。6 个月随访后,护士主导的方案组的平均空腹血糖和 HbA1c 更低,HbA1c<7.0%的患者比例也更高。护士主导的方案组的尿白蛋白肌酐比值中位数和微量白蛋白尿发生率也更低。护士主导的方案与达到 HbA1c<7.0%的可能性增加 32%以及微量白蛋白尿发生率降低 11%相关。在校正了协变量后,护士主导的方案仍与达到 HbA1c<7.0%的可能性增加 32%以及微量白蛋白尿发生率降低 11%相关。这些获益在性别和年龄上是一致的,而在肥胖或高血压患者中获益更大(P 交互<.05)。护士主导的方案有利于血糖控制和预防微量白蛋白尿。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb71/9575708/7b42349878d6/medi-101-e30693-g001.jpg

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