在新诊断为糖尿病的乌干达成年人中,2 型糖尿病的进展:一项观察性前瞻性研究。
Type 2 diabetes progression in an adult Ugandan population with new-onset diabetes: an observational prospective study.
机构信息
Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Non-Communicable Diseases Program, Entebbe, Uganda.
Department of Non-Communicable Diseases Epidemiology, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK.
出版信息
BMC Prim Care. 2023 Oct 19;24(1):214. doi: 10.1186/s12875-023-02169-4.
BACKGROUND
The rate of progression of type 2 diabetes following diagnosis varies across individuals and populations. Studies investigating the progression of type 2 diabetes in adult African populations with newly diagnosed diabetes are limited. We aimed to investigate the prevalence and predictors of short-term (one year) diabetes progression in an adult Ugandan population with new-onset type 2 diabetes (type 2 diabetes diagnosed in < 3 months) initiated on oral hypoglycaemic agents (OHA).
METHODS
Two hundred and seven adult participants with type 2 diabetes diagnosed within the previous three months were followed up for 12 months. We investigated the association of specific demographic, clinical, and metabolic characteristics, and short-term diabetes progression (defined as glycated haemoglobin or HbA1c ≥ 8% on ≥ 2 OHA and/or treatment intensification).
RESULTS
One hundred sixteen participants (56%) completed the follow-up period. Sixty-four participants (55.2%, 95% CI 45.7-64.4) showed evidence of diabetes progression during the 12-month period of follow-up. An HbA1c ≥ 8% on ≥ 2 OHA and treatment intensification were noted in 44.8% and 29.3% of the participants, respectively. On multivariate analysis, only the female gender (AOR 3.2, 95% CI 1.1-9.2, p = 0.03) was noted to be independently associated with short-term diabetes progression.
CONCLUSION
Short-term diabetes progression was relatively common in this study population and was independently associated with the female gender. Early intensified diabetes therapy in adult Ugandan female patients with new-onset type 2 diabetes should be emphasised to avert rapid short-term diabetes progression.
背景
2 型糖尿病(type 2 diabetes)确诊后的进展速度因个体和人群而异。针对新诊断为 2 型糖尿病的成年非洲人群中 2 型糖尿病进展情况的研究较为有限。我们旨在调查乌干达成年新诊断为 2 型糖尿病(type 2 diabetes diagnosed in < 3 months)患者中,接受口服降糖药(oral hypoglycaemic agents,OHA)治疗的人群在短期内(1 年)糖尿病进展的患病率和预测因素。
方法
对 207 名在过去 3 个月内确诊为 2 型糖尿病的成年参与者进行了为期 12 个月的随访。我们研究了特定的人口统计学、临床和代谢特征与短期糖尿病进展(定义为糖化血红蛋白或 HbA1c≥8%,至少使用 2 种 OHA 和/或治疗强化)之间的关联。
结果
106 名参与者(56%)完成了随访期。64 名参与者(55.2%,95%置信区间 45.7-64.4)在 12 个月的随访期间出现了糖尿病进展的证据。44.8%和 29.3%的参与者分别出现了 HbA1c≥8%,且至少使用 2 种 OHA 和治疗强化。多变量分析显示,只有女性性别(优势比 3.2,95%置信区间 1.1-9.2,p=0.03)与短期糖尿病进展独立相关。
结论
在本研究人群中,短期糖尿病进展较为常见,与女性性别独立相关。在乌干达成年新发 2 型糖尿病女性患者中,应强调早期强化糖尿病治疗,以避免短期糖尿病快速进展。