埃塞俄比亚西北部贡德尔大学综合专科医院 2 型糖尿病患者血糖控制不佳的决定因素：非匹配病例对照研究。

Determinants of poor glycemic control among type 2 diabetes mellitus patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched case-control study.

机构信息

Department of Internal Medicine, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.

出版信息

Front Endocrinol (Lausanne). 2023 Feb 9;14:1087437. doi: 10.3389/fendo.2023.1087437. eCollection 2023.

DOI:10.3389/fendo.2023.1087437

PMID:36843610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9947343/

Abstract

BACKGROUND

Poor glycemic control is one of the most determinant factors for type 2 diabetes-related morbidity and mortality. The proportion of type 2 diabetes mellitus patients with poor glycemic control remains high. Yet evidence on factors contributing to poor glycemic control remains scarce. The aim of this study is to identify determinants of poor glycemic control among type 2 diabetes mellitus patients at a diabetes mellitus clinic in University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia Determinants of Poor Glycemic Control among Type 2 Diabetes mellitus Patients at University of Gondar Comprehensive Specialized Hospital, Northwest Ethiopia: Unmatched Case-Control Study.

METHODS

A hospital-based case-control study was conducted from June to September 2020. Using convenience sampling techniques, a total of 90 cases and 90 controls with type 2 diabetes were recruited. The data were entered into Epidata version 4.6.0.2 and analyzed by Stata version 14. A multivariable logistic regression analysis was performed to assess the association between independent variables and glycemic control. Both 95% CI and p-value<0.05 were used to determine the level and significance, respectively.

RESULTS

The mean age ( ± standard deviations) for the cases and controls were 57.55± 10.42 and 61.03± 8.93% respectively. The determinants of poor glycemic control were age (Adjusted odd ratio (AOR)= 0.08; 95% CI= 0.02-0.33), inadequate physical exercise (AOR = 5.05; 95% CI = 1.99-11.98), presence of comorbidities (AOR = 5.50; 95% CI = 2.06-14.66), non-adherence to anti-diabetes medications (AOR= 2.76; 95% CI= 1.19-6.40), persistent proteinuria (AOR=4.95; 95% CI=1.83-13.36) and high-density lipoprotein less than 40 mg/dl (AOR=3.08; 95% CI= 1.30-7.31).

CONCLUSIONS

Age less than 65 years, inadequate physical exercise, presence of comorbidities, non-adherence to anti-diabetes medications, persistent proteinuria, and high-density lipoprotein less than 40 mg/dl were the determinants of poor glycemic control. Therefore, targeted educational and behavioral modification programs on adequate exercise and medication adherence should be routinely practiced. Furthermore, early guideline-based screening and treatment of comorbidities and complications is required to effectively manage diabetes mellitus.

摘要

背景

血糖控制不佳是 2 型糖尿病相关发病率和死亡率的最重要决定因素之一。血糖控制不佳的 2 型糖尿病患者比例仍然很高。然而，关于导致血糖控制不佳的因素的证据仍然很少。本研究旨在确定在埃塞俄比亚贡德尔大学综合专科医院的糖尿病诊所中，2 型糖尿病患者血糖控制不佳的决定因素。

方法

这是一项 2020 年 6 月至 9 月在医院进行的病例对照研究。使用便利抽样技术，共招募了 90 例 2 型糖尿病病例和 90 例对照。数据输入到 Epidata 版本 4.6.0.2 并由 Stata 版本 14 进行分析。采用多变量逻辑回归分析评估独立变量与血糖控制之间的关系。均使用 95%CI 和 p 值<0.05 分别确定水平和显著性。

结果

病例组和对照组的平均年龄（±标准差）分别为 57.55±10.42 和 61.03±8.93%。血糖控制不佳的决定因素包括年龄（调整后的优势比（AOR）=0.08；95%CI=0.02-0.33）、身体活动不足（AOR=5.05；95%CI=1.99-11.98）、合并症存在（AOR=5.50；95%CI=2.06-14.66）、抗糖尿病药物不依从（AOR=2.76；95%CI=1.19-6.40）、持续性蛋白尿（AOR=4.95；95%CI=1.83-13.36）和高密度脂蛋白<40mg/dl（AOR=3.08；95%CI=1.30-7.31）。