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[老年糖尿病患者糖尿病负担增加的相关因素]

[Factors associated with increased diabetes burden in elderly diabetic patients].

作者信息

Araki A, Izumo Y, Inoue J, Takahashi R, Takanashi K, Teshima T, Yatomi N, Shimizu Y, Ito H

机构信息

Section of Endocrinology, Tokyo Metropolitan Geriatic Hospital.

出版信息

Nihon Ronen Igakkai Zasshi. 1995 Dec;32(12):797-803. doi: 10.3143/geriatrics.32.797.

Abstract

To define the factors that determine the increased burden of diabetes in elderly diabetic patients, we examined the relationship between the Elderly Diabetes Impact Scales (EDIS) and physical or social factors in 383 elderly outpatients aged over 60 years old who answered QOL questionnaires by professional interviewers. The EDIS consisted of 6 subscales (burden of symptoms, burden of daily life, burden of diet therapy, burden of drug therapy, satisfaction, worry) and total EDIS scores were calculated by summing up the 4-point scores of 37 questions. The EDIS scores were highest in patients who received insulin therapy. In univariate analysis, high EDIS scores were significantly associated with high HbA1c, low Roken ADL score, and the presence of retinopathy or neuropathy. Among social factors, leisure activities, housework or jobs, social network, and positive social support were significantly associated with low EDIS scores, while negative social support was associated with high EDIS scores in elderly diabetic patients. Multiple linear regression analysis revealed that age (younger), sex (women), low ADL (or diabetic complications), insulin therapy, low positive social support, high negative social support, economical dissatisfaction, and the low adaptative feeling of diabetes were significant and independent determinants of a high burden in diabetic patients indicated by EDIS scores in Japanese elderly diabetic patients.

摘要

为了确定导致老年糖尿病患者糖尿病负担加重的因素,我们对383名60岁以上的老年门诊患者进行了研究,这些患者由专业访谈人员进行生活质量问卷调查,我们考察了老年糖尿病影响量表(EDIS)与身体或社会因素之间的关系。EDIS由6个分量表组成(症状负担、日常生活负担、饮食治疗负担、药物治疗负担、满意度、担忧),EDIS总分通过将37个问题的4分制得分相加得出。接受胰岛素治疗的患者EDIS得分最高。在单因素分析中,较高的EDIS得分与较高的糖化血红蛋白、较低的洛肯日常生活活动能力得分以及视网膜病变或神经病变的存在显著相关。在社会因素中,休闲活动、家务或工作、社交网络和积极的社会支持与较低的EDIS得分显著相关,而消极的社会支持与老年糖尿病患者较高的EDIS得分相关。多元线性回归分析显示,年龄(较轻)、性别(女性)、较低的日常生活活动能力(或糖尿病并发症)、胰岛素治疗、较低的积极社会支持、较高的消极社会支持、经济不满以及较低的糖尿病适应感是日本老年糖尿病患者中EDIS得分所表明的糖尿病高负担的显著且独立的决定因素。

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