School of Nursing at Higher Colleges of Technology, Fujairah 1626, United Arab Emirates.
Nursing Program at The University of Texas Health Science Center-Houston, Cizik School of Nursing, 6901 Bertner Avenue, Ste. 580, Houston, TX 77030, USA.
Prim Care Diabetes. 2023 Aug;17(4):392-400. doi: 10.1016/j.pcd.2023.04.003. Epub 2023 Apr 18.
BACKGROUND: Adolescents with Type 1 Diabetes (T1D) display a greater than two-fold higher risk of developing diabetes-related complications compared with their healthy peers and the risk increases markedly as glycated hemoglobin (HbA1c) increases. The majority of the known factors associated with improved glycemic control in adolescents with T1D are geared toward Western populations. Therefore, this study examined the associations between Physical Activity (PA), Health-Related Quality of Life (HRQoL), and regimen adherence on glycemic control in a Middle Eastern population of adolescents with T1D METHODS: The study utilized a cross-sectional design of Jordanian adolescents (aged 12-18) with T1D (n = 74). Self-reported measures used were the Pediatric Quality of Life-Diabetes Module, the International Physical Activity Questionnaire, and the Summary of Diabetes Self-Care Activities. HbA1c values were obtained from the medical records. Correlation analyses were conducted using Pearson's and Spearman's correlation tests. Multiple regression analyses were conducted to determine if HRQoL, PA, and regimen adherence predict glycemic control. RESULTS: Only 14.8 % of the participants demonstrated good glycemic control (HbA1c ≤ 7.5 %). Participants with poor control had a statistically significant lower mean PA of MET-minutes/week (3531.9 ± 1356.75 vs. 1619.81 ± 1481.95, p < .001) compared to those with good control. The total sample was found to demonstrate low HRQoL (47.70 ± 10.32). Participants were within the acceptable range of PA (1885.38 ± 1601.13) MET-minutes/week. HbA1c significantly inversely correlated with PA (r = -0.328, p = .010) and regimen adherence (r = -0.299, p = .018). The regression analysis revealed that PA significantly predicted glycemic control (β = -0.367, p < .01) as adherence (β = -0.409, p < .01) and disease duration did (β = 0.444, p < .01). CONCLUSION: Better glycemic control was significantly associated with higher PA and regimen adherence levels. The correlation between PA and glycemic control depends highly on the level of regimen adherence or arguably, adherence acts as a buffer in the correlation between PA and glycemic control. There was no significant association between glycemic control and HRQoL.
背景：与健康同龄人相比，1 型糖尿病（T1D）青少年发生糖尿病相关并发症的风险高出两倍以上，而且随着糖化血红蛋白（HbA1c）的升高，风险显著增加。大多数与 T1D 青少年血糖控制改善相关的已知因素都针对西方人群。因此，本研究在中东 T1D 青少年人群中，检查了身体活动（PA）、健康相关生活质量（HRQoL）和治疗方案依从性与血糖控制之间的关系。
方法：本研究采用约旦 T1D 青少年（12-18 岁）的横断面设计（n=74）。使用的自我报告措施包括儿科生活质量-糖尿病模块、国际体力活动问卷和糖尿病自我护理活动综合摘要。从病历中获得 HbA1c 值。使用 Pearson 和 Spearman 相关检验进行相关性分析。进行多元回归分析以确定 HRQoL、PA 和治疗方案依从性是否可以预测血糖控制。
结果：只有 14.8%的参与者血糖控制良好（HbA1c≤7.5%）。血糖控制不佳的参与者每周平均 PA 的梅脱分钟数（3531.9±1356.75 vs. 1619.81±1481.95，p<.001）显著低于血糖控制良好的参与者。总体样本的 HRQoL 较低（47.70±10.32）。参与者的 PA 处于可接受范围（1885.38±1601.13）梅脱分钟/周。HbA1c 与 PA 呈显著负相关（r=-0.328，p=.010）和治疗方案依从性（r=-0.299，p=.018）。回归分析显示，PA 显著预测血糖控制（β=-0.367，p<.01），而依从性（β=-0.409，p<.01）和疾病持续时间（β=0.444，p<.01）也有显著预测作用。
结论：更好的血糖控制与更高的 PA 和治疗方案依从性水平显著相关。PA 与血糖控制之间的相关性高度依赖于治疗方案依从性的水平，或者可以说，依从性在 PA 与血糖控制之间的相关性中起到了缓冲作用。血糖控制与 HRQoL 之间没有显著关联。
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