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伊朗北部2型糖尿病患者的血糖失控及相关因素:自我护理和自我效能的作用

Uncontrolled glycemia and the associated factors in Iranian type 2 diabetic patients, North of Iran: Role of self-care and self-efficacy.

作者信息

Geraili Zahra, Hajian-Tilaki Karimolla, Meftah Neda

机构信息

Student Research Committee, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.

Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran.

出版信息

Caspian J Intern Med. 2025 Mar 21;16(2):336-346. doi: 10.22088/cjim.16.2.336. eCollection 2025 Spring.

Abstract

BACKGROUND

Hyperglycemia caused by diabetes is closely related to long-term damage in organ functional disorders. The objective of the study was to determine the prevalence of uncontrolled glycemia and its associated factors in Iranian diabetic patients.

METHODS

This cross-sectional study was conducted on 496 types 2 diabetic patients in the outpatient clinic of a referral hospital center affiliated with Babol University of Medical Sciences, North of Iran. The data of fasting blood sugar (FBS) and hemoglobin A1C were extracted from recent laboratory tests. The demographic, clinical data, and comorbidity were collected. The reliable and valid scales of self-care and self-efficacy were used to collect data through face-to-face interviews with patients.

RESULTS

About half of the participants, 241(48.6%) patients had poor glycemic control (FBS≥152 mg/dl) and a higher proportion, 382 (79.6%) patients were found based on the criterion of HbA1C≥7%. There was no significant difference in poor glycemic control between genders. The adjusted OR for risk of poor glycemic control (FBS>152mg/dl) after controlling potential confounders was 2.37 (95%CI: 1.34, 4.12) for the duration of diabetes >15 years compared to 5 years or less. The higher level of self-efficacy prevented poor glycemic control (adjusted OR=0.50, 95%CI: 0.29, 0.87). While the high level of self-care tended to protect against poor glycemic control non-significantly (adjusted OR=0.65, 95%CI: 0.41, 1.11).

CONCLUSION

Our findings show that majority of diabetic patients have poor glycemic control. The high level of self-care and self-efficacy substantially reduced the risk of poor glycemic control.

摘要

背景

糖尿病引起的高血糖与器官功能障碍的长期损害密切相关。本研究的目的是确定伊朗糖尿病患者血糖控制不佳的患病率及其相关因素。

方法

本横断面研究在伊朗北部马赞德兰医科大学附属转诊医院中心的门诊对496例2型糖尿病患者进行。空腹血糖(FBS)和糖化血红蛋白A1C的数据从近期实验室检查中提取。收集人口统计学、临床数据和合并症信息。通过与患者面对面访谈,使用可靠有效的自我护理和自我效能量表收集数据。

结果

约一半的参与者,即241例(48.6%)患者血糖控制不佳(FBS≥152mg/dl),基于糖化血红蛋白A1C≥7%的标准,发现更高比例的患者,即382例(79.6%)。血糖控制不佳在性别之间无显著差异。在控制潜在混杂因素后,糖尿病病程>15年的患者血糖控制不佳(FBS>152mg/dl)风险的调整后比值比为2.37(95%置信区间:1.34,4.12),而病程为5年或更短的患者。较高水平的自我效能可预防血糖控制不佳(调整后比值比=0.50,95%置信区间:0.29,0.87)。而高水平的自我护理倾向于对预防血糖控制不佳有非显著的保护作用(调整后比值比=0.65,95%置信区间:0.41,1.11)。

结论

我们的研究结果表明,大多数糖尿病患者血糖控制不佳。高水平的自我护理和自我效能可大幅降低血糖控制不佳的风险。

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本文引用的文献

1
Individualized Glycemic Control in Type 2 Diabetic Patients in Iran: A Multi-Center Data Analysis.
Iran J Med Sci. 2023 May;48(3):286-291. doi: 10.30476/ijms.2022.92805.2409.
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The Effect of Self-Efficacy in Self-Management on Diabetes Distress in Young People with Type 2 Diabetes.
Healthcare (Basel). 2021 Dec 15;9(12):1736. doi: 10.3390/healthcare9121736.
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Management of Kidney Failure in Patients with Diabetes Mellitus: What Are the Best Options?
J Clin Med. 2021 Jun 30;10(13):2943. doi: 10.3390/jcm10132943.
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Evaluating the quality of care for patients with type 2 diabetes mellitus based on the HbA1c: A national survey in Iran.
Heliyon. 2021 Mar 17;7(3):e06485. doi: 10.1016/j.heliyon.2021.e06485. eCollection 2021 Mar.

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