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关于改善刚果民主共和国金沙萨 2 型糖尿病患者血糖控制的潜在干预措施的共识:一项德尔菲研究。

Consensus on potential interventions for improving glycaemic control among patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo: a Delphi study.

机构信息

Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.

Department of Family Medicine and Primary Care, Protestant University of the Congo, Kinshasa, Democratic Republic of the Congo.

出版信息

Glob Health Action. 2023 Dec 31;16(1):2247894. doi: 10.1080/16549716.2023.2247894.

Abstract

BACKGROUND

Poor glycaemic control is a multifactorial and complex problem with dire clinical and economic implications. In the Democratic Republic of the Congo, recent studies have shown alarming poor control rates. There is no policy framework to guide corrective actions.

OBJECTIVES

To build a consensus on interventions to improve glycaemic control among patients with type 2 diabetes in Kinshasa, Democratic Republic of the Congo.

METHODS

This was a two-round electronic Delphi study involving 31 local and 5 international experts. The experts rated proposed interventions from previous studies on glycaemic control in sub-Saharan Africa and Kinshasa on a 4-Likert scale questionnaire. Additionally, the experts were asked to suggest other recommendations useful for the purpose. The mode, mean and standard deviation of each statement were calculated for each round.

RESULTS

Participants reached consensus in five domains that included 39 statements on how to improve glycaemic control in Kinshasa: strengthening the health system, enhancing the awareness of diabetes, alleviating the financial burden of diabetes, enhancing the adoption of lifestyle modifications, and reducing the proportion of undiagnosed diabetes.

CONCLUSIONS

Improved glycaemic control needs to be considered within the broader framework of managing noncommunicable diseases in a more integrated, coordinated and better financed healthcare system. Further studies are needed to operationalise the interventions identified for successful implementation.

摘要

背景

血糖控制不佳是一个多因素且复杂的问题,会带来严重的临床和经济影响。在刚果民主共和国,最近的研究表明,血糖控制率令人震惊地差。目前没有政策框架来指导纠正措施。

目的

就改善刚果民主共和国金沙萨 2 型糖尿病患者的血糖控制问题达成共识。

方法

这是一项涉及 31 名当地专家和 5 名国际专家的两轮电子德尔菲研究。专家们对之前研究中针对撒哈拉以南非洲和金沙萨的血糖控制提出的干预措施进行了 4 级李克特量表问卷调查。此外,专家们还被要求提出其他有助于实现这一目标的建议。对每一轮的每一条陈述,计算了模式、平均值和标准差。

结果

参与者在五个领域达成了共识,其中包括 39 条关于如何改善金沙萨血糖控制的陈述:加强卫生系统、提高对糖尿病的认识、减轻糖尿病的经济负担、促进生活方式的改变、降低未确诊糖尿病的比例。

结论

需要在更具整合性、协调性和资金更充足的医疗保健系统中管理非传染性疾病的更广泛框架内考虑改善血糖控制。需要进一步研究以确定可成功实施的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c7ba/10461491/24031b6d3a90/ZGHA_A_2247894_F0001_OC.jpg

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