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接受治疗的糖尿病患者实现最佳血糖控制的时间及其决定因素:一项回顾性研究。

Time to achieve optimal glycemic control and its determinants among diabetes mellitus patients receiving treatment: a retrospective study.

作者信息

Kassie Maru Zewdu, Alemu Chekol, Wudu Habitamu, Marine Buzuneh Tasfa, Gebeyehu Asaye Alamneh

机构信息

Department of Statistics, College of Natural and Computational Sciences, Assosa University, Assosa, Ethiopia.

Department of Statistics, College of Natural and Computational Sciences, Gambella University, Gambella, Ethiopia.

出版信息

Sci Rep. 2025 Jun 6;15(1):20031. doi: 10.1038/s41598-025-96097-1.

Abstract

Diabetes mellitus (DM) is a major public health problem responsible for morbidity and mortality. Maintaining blood sugar control helps patients achieve optimal glycemic levels. Therefore, this study aimed to identify the factors affecting the time to achieve optimal glycemic control among DM patients at Assosa General Hospital (AGH), Western Ethiopia. A retrospective study design was conducted from 427 randomly selected DM patients in the outpatient department (OPD) clinic at AGH under the follow-up period from September 2022 to September 2024. The median survival time, Kaplan-Meier survival estimate, and Log-Rank test were used to describe the data and compare the survival time between groups. The study used Cox PH model to analyze the time to achieve optimal glycemic control of DM patients, where hazard ratio, p-value, and 95% CI for hazard ratio were used for testing significance. Schoenfeld and Cox-Snell residuals were used to check the model assumptions. The median time to optimal glycemic control for DM patients was 12 months. At the end of the follow-up, 74.2% of the patients had developed an event and the rest 25.8% were censored. The significant predictors of time to optimal glycemic control include: older age (AHR = 0.871(95% CI 0.809, 0.937)), females (AHR = 1.295 (95% CI 1.024, 1.639)), having FHDM (AHR = 1.681(95% CI 1.313, 2.153)), rural residence(AHR = 0.463(95% CI 0.354, 0.607)), presence of comorbidity (AHR = 0.508(95% CI 0.302, 0.854)), DM related complications (AHR = 0.419(95% CI 0.326, 0.539)), high BLBGL AHR = 0.997(95% CI 0.995, 0.998)). This study found the factors that prolonged or shortened the time to reach optimal glycaemic control for T2DM patients. The study revealed that older age, male patients, patients having other related comorbidities and patients with no FHDM, patients having DM-related complications as poor prognostic factors of T2DM disease and also prolonged recovery time. Therefore, attention should be given to these patients to obtain good glycaemic levels and the patient being healthy.

摘要

糖尿病(DM)是一个导致发病和死亡的主要公共卫生问题。维持血糖控制有助于患者达到最佳血糖水平。因此,本研究旨在确定影响埃塞俄比亚西部阿索萨综合医院(AGH)糖尿病患者达到最佳血糖控制时间的因素。采用回顾性研究设计,对2022年9月至2024年9月随访期间在AGH门诊部(OPD)诊所随机选取的427例糖尿病患者进行研究。采用中位生存时间、Kaplan-Meier生存估计和Log-Rank检验来描述数据并比较组间生存时间。本研究使用Cox PH模型分析糖尿病患者达到最佳血糖控制的时间,其中风险比、p值和风险比的95%置信区间用于检验显著性。使用Schoenfeld残差和Cox-Snell残差来检验模型假设。糖尿病患者达到最佳血糖控制的中位时间为12个月。随访结束时,74.2%的患者发生了事件,其余25.8%被截尾。达到最佳血糖控制时间的显著预测因素包括:年龄较大(AHR = 0.871(95% CI 0.809, 0.937))、女性(AHR = 1.295 (95% CI 1.024, 1.639))、患有FHDM(AHR = 1.681(95% CI 1.313, 2.153))、农村居住(AHR = 0.463(95% CI 0.354, 0.607))、存在合并症(AHR = 0.508(95% CI 0.302, 0.854))、糖尿病相关并发症(AHR = 0.419(95% CI 0.3, 0.539))、高BLBGL(AHR = 0.997(95% CI 0.995, 0.998))。本研究发现了延长或缩短2型糖尿病患者达到最佳血糖控制时间的因素。该研究表明,年龄较大、男性患者、患有其他相关合并症的患者、没有FHDM的患者、患有糖尿病相关并发症的患者是2型糖尿病疾病的不良预后因素,也是恢复时间延长的因素。因此,应关注这些患者以获得良好的血糖水平并保持健康。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1250/12144107/52acec509a98/41598_2025_96097_Fig1_HTML.jpg

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