School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, China.
Int J Environ Res Public Health. 2022 Oct 30;19(21):14175. doi: 10.3390/ijerph192114175.
Regular follow-up attendance in primary care and routine blood glucose monitoring are essential in diabetes management, particularly for patients at higher cardiovascular (CV) risk. We sought to examine the regularity of follow-up attendance and blood glucose monitoring in a primary care sample of type 2 diabetic patients at moderate-to-high CV risk, and to explore factors associated with poor engagement. Cross-sectional data were collected from 2130 patients enrolled in a diabetic retinopathy screening programme in Guangdong province, China. Approximately one-third of patients (35.9%) attended clinical follow-up <4 times in the past year. Over half of patients (56.9%) failed to have blood glucose monitored at least once per month. Multivariable logistic regression analysis showed that rural residents (adjusted odds ratio [aOR] = 0.420, 95% confidence interval [CI] = 0.338-0.522, < 0.001, for follow-up attendance; aOR = 0.580, 95%CI: 0.472-0.712, < 0.001, for blood glucose monitoring) and subjects with poor awareness of adverse consequences of diabetes complications (aOR = 0.648, 95%CI = 0.527-0.796, < 0.001, for follow-up attendance; aOR = 0.770, 95%CI = 0.633-0.937, = 0.009, for blood glucose monitoring) were both less likely to achieve active engagement. Our results revealed an urban-rural divide in patients' engagement in follow-up attendance and blood glucose monitoring, which suggested the need for different educational approaches tailored to the local context to enhance diabetes care.
在糖尿病管理中,定期在初级保健机构就诊和常规血糖监测至关重要,尤其是对于心血管(CV)风险较高的患者。我们旨在研究中等至高度 CV 风险的 2 型糖尿病患者在初级保健样本中的随访就诊和血糖监测的规律性,并探讨与较差参与度相关的因素。横断面数据来自中国广东省的一项糖尿病视网膜病变筛查计划,共纳入 2130 名患者。大约三分之一的患者(35.9%)在过去一年中就诊次数<4 次。超过一半的患者(56.9%)未能每月至少监测一次血糖。多变量逻辑回归分析显示,农村居民(调整后的优势比[aOR] = 0.420,95%置信区间[CI] = 0.338-0.522, < 0.001,用于随访就诊;aOR = 0.580,95%CI:0.472-0.712, < 0.001,用于血糖监测)和对糖尿病并发症不良后果认知不足的患者(aOR = 0.648,95%CI = 0.527-0.796, < 0.001,用于随访就诊;aOR = 0.770,95%CI = 0.633-0.937, = 0.009,用于血糖监测)都不太可能积极参与。我们的研究结果揭示了患者在随访就诊和血糖监测方面的城乡差距,这表明需要根据当地情况制定不同的教育方法,以加强糖尿病护理。