在埃塞俄比亚西北部阿姆哈拉地区综合专科医院中，成年 2 型糖尿病患者达到最佳血糖控制的时间及其预测因素。

Time to first optimal glycemic control and its predictors among adult type 2 diabetes patients in Amhara Regional State comprehensive specialized hospitals, Northwest Ethiopia.

机构信息

Dega Damot District Health Office, West Gojjam Zone, Amhara Region, Feresbet, Ethiopia.

Department of Public Health, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia.

出版信息

BMC Endocr Disord. 2024 Aug 30;24(1):169. doi: 10.1186/s12902-024-01695-1.

DOI:10.1186/s12902-024-01695-1

PMID:39215294

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11363452/

Abstract

BACKGROUND

Inadequate glycemic management in type 2 diabetes Mellitus patients is a serious public health issue and a key risk factor for progression as well as diabetes-related complications. The main therapeutic goal of preventing organ damage and other problems caused by diabetes is glycemic control. Knowing when to modify glycemic control in type 2 diabetes Mellitus is crucial for avoiding complications and early drug intensifications.

METHODS

An institutional based retrospective follow-up study was undertaken among 514 eligible adult diabetes patients in Amhara region Comprehensive Specialized Hospitals, Northwest Ethiopia, from January 2017 to January 2022. Simple random sampling technique was used to select study participants. The Kaplan Meier curve was used to assess the survival status of categorical variables, and the log-rank test was used to compare them. The cox proportional hazard model was fitted to identify the predictors of time to first optimal glycemic control. Variables with a p-value < 0.05 were considered to be statistically significance at 95% confidence interval.

RESULTS

A total of 514 patient records (227 males and 287 females) were reviewed in this study. The median time to first optimal glycemic control among the study population was 8.4 months IQR (7.6-9.7). The predictors that affect the time to first optimal glycemic control were age group ((AHR = 0.63, 95% CI = 0.463, 0.859 for 50-59 years), (AHR = 0.638, 95% CI = 0.471, 0.865 for 60-69 years), and (AHR = 0.480, 95% CI = 0.298, 0.774 for > = 70 years)), diabetes neuropathy (AHR = 0.629, 95% CI = 0.441,0.900), hypertension (AHR = 0.667, 95% CI = 0.524, 0.848), dyslipidemia (AHR = 0.561, 95% CI = 0.410, 0.768), and cardiovascular disease (AHR = 0.681, 95% CI = 0.494, 0.938).

CONCLUSION

The median time to initial optimal glycemic control in type 2 diabetes Mellitus patients in this study was short. Age between 50 and 59 years and 60-69, diabetes neuropathy, hypertension, dyslipidemia, and cardiovascular disease were predictor's of time to first glycemic control. Therefore, health care providers should pay extra attention for patients who are aged and who have complications or co-morbidities.

摘要

背景

2 型糖尿病患者血糖控制不佳是一个严重的公共卫生问题，也是疾病进展和糖尿病相关并发症的关键风险因素。预防糖尿病引起的器官损害和其他问题的主要治疗目标是血糖控制。了解何时调整 2 型糖尿病患者的血糖控制对于避免并发症和早期药物强化至关重要。

方法

本研究为 2017 年 1 月至 2022 年 1 月在埃塞俄比亚西北部阿姆哈拉地区综合专科医院的 514 名成年糖尿病患者进行了一项基于机构的回顾性随访研究。采用简单随机抽样技术选择研究对象。Kaplan-Meier 曲线用于评估分类变量的生存状态，对数秩检验用于比较。采用 Cox 比例风险模型确定首次达到最佳血糖控制的预测因素。p 值<0.05 的变量被认为在 95%置信区间内具有统计学意义。

结果

本研究共回顾了 514 份患者记录（227 名男性和 287 名女性）。研究人群首次达到最佳血糖控制的中位时间为 8.4 个月 IQR（7.6-9.7）。影响首次达到最佳血糖控制时间的预测因素包括年龄组（（AHR=0.63，95%CI=0.463，0.859，50-59 岁），（AHR=0.638，95%CI=0.471，0.865，60-69 岁），和（AHR=0.480，95%CI=0.298，0.774，≥70 岁））、糖尿病神经病变（AHR=0.629，95%CI=0.441，0.900）、高血压（AHR=0.667，95%CI=0.524，0.848）、血脂异常（AHR=0.561，95%CI=0.410，0.768）和心血管疾病（AHR=0.681，95%CI=0.494，0.938）。