埃塞俄比亚 2 型糖尿病患者血糖控制不佳的决定因素：系统评价和荟萃分析。
Determinants of poor glycemic control among type 2 diabetes in Ethiopia: a systematic review and meta-analysis.
机构信息
Department of Nursing, College of Medicine and Health Science, Wollo University, Dessie, Ethiopia.
Department of Midwifery, College of Medicine and Health Science, Wolaita Sodo University, Sodo, Ethiopia.
出版信息
Front Public Health. 2024 Feb 5;12:1256024. doi: 10.3389/fpubh.2024.1256024. eCollection 2024.
INTRODUCTION
Prior primary studies have examined the prevalence and factors associated with glycaemic control among patients with type 2 diabetes mellitus, but studies with evidence-based synthesis of the primary data remained unknown. Hence, we aimed to determine the prevalence of poor glycemic control and identify determinants of poor glycemic control in patients with type 2 diabetes in Ethiopia.
METHODS
We performed searches in the online databases of PubMed, Google Scholar, Scopus, Science Direct, and the Cochrane Library. Microsoft Excel was used to extract data, and STATA statistical software (v. 16) was used for analysis. Publication bias was explored by forest plots, Begg's rank test, and Egger's regression test. To check for heterogeneity, I was computed. Subgroup analysis was conducted based on region and publication year. In addition, the pooled odds ratio for associated factors was calculated.
RESULTS
Out of 1,045 studies assessed, 23 studies were included fulfilling our inclusion criteria. In all, 6,643 individuals were enrolled in the study. It was estimated that 61.11% of type 2 diabetes patients had poor glycemic control (95% CI, 57.14-65.19). The subgroup analysis by study region and publication year revealed that the highest prevalence was observed in the Addis Ababa region (68.57%) and studies published before 2019 (61.76%), respectively. Poor glycemic control was associated with older age > 50 years (AOR = 2.12; 95% CI: 1.27-2.97), not attending formal education (AOR = 3.60; 95% CI: 2.75, 4.46), having diabetes for longer duration (10 years; AOR = 2.57; 95% CI: 1.65-3.49), having comorbidity (AOR = 2.43; 95% CI: 2.05-2.80), and low adherence to diabetes management (AOR = 3.67; 95% CI: 2.41-4.92).
CONCLUSION
Our findings indicate a high prevalence of poor glycemic control among people with type 2 diabetes in Ethiopia. Being older, not attending formal education, having a longer duration of diabetes, having comorbidity, and having low adherence to diabetes management were all associated. Therefore, we recommend health organizations implement measures to monitor and control patients' blood glucose levels. Patient education and training of healthcare professionals could serve as a short-term strategy to achieve adequate glycemic control.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO, identifier CRD42022349792, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349792.
简介
先前的主要研究已经考察了 2 型糖尿病患者血糖控制的流行情况和相关因素，但仍缺乏基于原始数据的证据综合研究。因此，我们旨在确定埃塞俄比亚 2 型糖尿病患者血糖控制不佳的流行情况，并确定血糖控制不佳的决定因素。
方法
我们在 PubMed、Google Scholar、Scopus、Science Direct 和 Cochrane Library 的在线数据库中进行了检索。使用 Microsoft Excel 提取数据，并使用 STATA 统计软件（v. 16）进行分析。通过森林图、贝格等级检验和埃格检验来探索发表偏倚。计算了 I 来检查异质性。根据地区和发表年份进行了亚组分析。此外，还计算了相关因素的合并优势比。
结果
在评估的 1045 项研究中，有 23 项符合我们的纳入标准。共有 6643 名个体纳入了这项研究。估计有 61.11%的 2 型糖尿病患者血糖控制不佳（95%CI，57.14-65.19）。按研究区域和发表年份进行的亚组分析表明，最高的患病率出现在亚的斯亚贝巴地区（68.57%）和 2019 年之前发表的研究（61.76%）。血糖控制不佳与年龄较大（>50 岁）（AOR=2.12；95%CI：1.27-2.97）、未接受正规教育（AOR=3.60；95%CI：2.75,4.46）、糖尿病病程较长（10 年）（AOR=2.57；95%CI：1.65-3.49）、合并症（AOR=2.43；95%CI：2.05-2.80）和糖尿病管理依从性低（AOR=3.67；95%CI：2.41-4.92）有关。
结论
我们的研究结果表明，埃塞俄比亚 2 型糖尿病患者的血糖控制不佳发生率较高。年龄较大、未接受正规教育、糖尿病病程较长、合并症以及糖尿病管理依从性低均与血糖控制不佳相关。因此，我们建议卫生组织实施措施来监测和控制患者的血糖水平。对患者进行教育和培训医疗保健专业人员可以作为实现良好血糖控制的短期策略。
系统评价注册
PROSPERO，标识符 CRD42022349792，https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022349792。
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