多学科糖尿病护理项目对地区及原住民社区血糖和代谢指标的影响：一项回顾性观察研究

Impact of a multidisciplinary diabetes care programme on glycaemic and metabolic outcomes in regional and First Nations communities: a retrospective observational study.

作者信息

Konantambigi Akash, Al-Abbood Majid, Weich Belinda, Barra Debbie, Hiskens Matthew, Marathe Chinmay, Malabu Usman, Deshmukh Harshal

机构信息

James Cook University, College of Medicine and Dentistry, Townsville, Queensland, Australia.

Mackay Health and Hospital Service, Townsville, Queensland, Australia.

出版信息

Intern Med J. 2025 Apr;55(4):637-644. doi: 10.1111/imj.16639. Epub 2025 Jan 17.

DOI:10.1111/imj.16639

PMID:39825477

Abstract

BACKGROUND

Type 2 diabetes mellitus (T2DM) poses a significant public health challenge in Australia, particularly among underserved populations such as First Nations people and rural communities. In response, the Together Strong Connected Care (TSCC) programme was developed to address these disparities by offering a culturally appropriate, multidisciplinary approach to diabetes management in a regional hospital setting.

AIMS

The aim of the study was to assess the impact of the TSCC programme on glycaemic and metabolic control in people living with diabetes.

METHODS

This was a retrospective observational study. Baseline characteristics, including age, gender, ethnicity and clinical measures, were collected. The primary outcome was the change in HbA1c over 12 months. Statistical analysis included descriptive analysis, univariate comparative analysis, paired t-tests for change in outcomes and multivariate linear regression analysis.

RESULTS

The study included 119 patients, divided into those who participated in the TSCC programme (n = 68) and those who declined participation (n = 51). The study participants had a mean age of 55.71 years, with 58.82% identifying as female. The mean baseline HbA1c was 8.25% (SD = 2.60) and mean baseline weight was 97.38 kg (SD = 28.81). People in the TSCC group had significantly greater reductions in HbA1c (-1.65%, P < 0.001) compared to the no-TSCC group (+0.02%, P < 0.001). After adjusting for confounders, TSCC participation remained independently associated with improved glycaemic control (β = -0.78, P < 0.001), particularly in patients with T2DM.

CONCLUSIONS

The TSCC programme significantly improved glycaemic control in regional First Nations patients, supporting the effectiveness of culturally appropriate, multidisciplinary care models in managing diabetes in underserved communities. Further research is warranted to evaluate long-term outcomes of similar interventions.

摘要

背景

2型糖尿病（T2DM）在澳大利亚构成了重大的公共卫生挑战，尤其是在原住民和农村社区等服务不足的人群中。作为回应，“共同强大互联护理”（TSCC）项目应运而生，通过在地区医院环境中提供符合文化背景的多学科糖尿病管理方法来解决这些差异。

目的

本研究的目的是评估TSCC项目对糖尿病患者血糖和代谢控制的影响。

方法

这是一项回顾性观察研究。收集了包括年龄、性别、种族和临床指标在内的基线特征。主要结局是12个月内糖化血红蛋白（HbA1c）的变化。统计分析包括描述性分析、单变量比较分析、结局变化的配对t检验和多变量线性回归分析。

结果

该研究纳入了119名患者，分为参与TSCC项目的患者（n = 68）和拒绝参与的患者（n = 51）。研究参与者的平均年龄为55.71岁，其中58.82%为女性。平均基线HbA1c为8.25%（标准差 = 2.60），平均基线体重为97.38千克（标准差 = 28.81）。与未参与TSCC项目的组（+0.02%，P < 0.001）相比，TSCC组的HbA1c显著降低（-1.65%，P < 0.001）。在调整混杂因素后，参与TSCC项目仍与改善血糖控制独立相关（β = -0.78，P < 0.001），尤其是在T2DM患者中。