Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia
Clinical Pharmacy, University of Gondar College of Medicine and Health Sciences, Gondar, Ethiopia.
BMJ Open. 2022 Sep 7;12(9):e065250. doi: 10.1136/bmjopen-2022-065250.
This study was aimed to determine the level of glycaemic control and associated factors in patients with type 2 diabetes mellitus (T2DM) treated with insulin-based therapy.
Institutional-based multicentre cross-sectional study design was employed to conduct this study.
The diabetes follow-up clinics of selected hospitals in Northwest Ethiopia.
Adult patients with T2DM treated with insulin-based therapy at the selected hospitals who met the eligibility criteria were the study participants.
Good glycaemic control; when fasting blood glucose (FBG) level ranged from 70 to 130 mg/dL, and FBG <70 and >130 mg/dL was considered poor glycaemic control. A logistic regression model was used to identify determinants of poor glycaemic control. A p<0.05 at 95% CI was statistically significant.
Of 403 study participants, 54.8% were males with a mean age of 55.03±10.8 years. Though patients with T2DM were treated with insulin-based therapy, most of the participants (72.5%) could not achieve the target FBG. The overall mean FBG was 177.1±54.3, and far from the target glucose level. Patients who could not practise self-monitoring of blood glucose were found more likely to have poor glycaemic control compared with those who practised self-monitoring (p<0.001). Whereas patients who had a normal body mass index (p=0.011) and who were treated with premixed insulin-based therapy (p=0.04) were found less likely to have poor glycaemic control compared with patients with obesity and who received NPH insulin based-regimens, respectively.
This study demonstrated that a significant proportion of the study samples could not achieve glycaemic targets and the average blood glucose was far higher than the recommended glycaemic target level. Insulin initiation and titration, considering the determinants of glycaemic control, could be recommended to achieve target glycaemic levels.
本研究旨在确定接受胰岛素治疗的 2 型糖尿病（T2DM）患者的血糖控制水平及其相关因素。
采用基于机构的多中心横断面研究设计进行本研究。
在埃塞俄比亚西北部选定医院的糖尿病随访诊所。
符合入选标准的接受胰岛素治疗的 T2DM 成年患者为研究对象。
良好的血糖控制；当空腹血糖（FBG）水平在 70 至 130mg/dL 之间，FBG<70 和>130mg/dL 时则认为血糖控制不佳。使用逻辑回归模型来确定血糖控制不佳的决定因素。95%CI 中 p<0.05 为统计学显著。
在 403 名研究参与者中，54.8%为男性，平均年龄为 55.03±10.8 岁。尽管 T2DM 患者接受了胰岛素治疗，但大多数患者（72.5%）无法达到目标 FBG。总体平均 FBG 为 177.1±54.3，远未达到目标血糖水平。与进行自我血糖监测的患者相比，无法进行自我血糖监测的患者更有可能血糖控制不佳（p<0.001）。而与肥胖患者和接受 NPH 胰岛素方案的患者相比，具有正常体重指数的患者（p=0.011）和接受预混胰岛素治疗的患者（p=0.04）血糖控制不佳的可能性较小。
本研究表明，相当一部分研究样本无法达到血糖目标，平均血糖水平远高于推荐的血糖目标水平。考虑血糖控制的决定因素，启动和调整胰岛素治疗可能有助于达到目标血糖水平。
