《2013年糖尿病护理研究：马来西亚一项基于医院的糖尿病护理服务及糖尿病相关并发症预防的横断面研究》

DiabCare 2013: A cross-sectional study of hospital based diabetes care delivery and prevention of diabetes related complications in Malaysia.

作者信息

Mafauzy M, Zanariah H, Nazeri A, Chan S P

机构信息

Universiti Sains Malaysia, Kota Bharu, Malaysia.

Hospital Putrajaya, Putrajaya, Wilayah Persekutuan Putrajaya, Malaysia.

出版信息

Med J Malaysia. 2016 Aug;71(4):177-185.

PMID:27770116

Abstract

AIMS

The aim of the study was to re-evaluate the relationship between hospital based diabetes care delivery and prevention of complications.

METHODS

DiabCare is an observational, non-interventional, cross-sectional study of hospital-based outpatient diabetes care.

RESULTS

A total of 1668 patients participated in the study: mean age 57.8 ± 11.0 years, duration of diabetes 13.0 ± 8.6 years, and duration of insulin treatment 5.6 ± 5.5 years. Mean weight was 74.3 ± 16.6 kg (BMI 29.1 ± 5.8 kg/m2). The majority of patients were female (53.6%) and the largest ethnic group was Malay (51.3%), followed by Indian (21.9%) and Chinese (20.1%). The percentage of patients with HbA1c < 6.5% (< 42 mmol/mol) and < 7.0% (< 53 mmol/mol) was 12.2% and 23.8%, respectively (mean HbA1c 8.52 ± 2.01% [70 ± 22 mmol/mol]). The proportion of patients using insulin was 65% at a total daily dose of 60 ± 37 IU. One or more episodes of hypoglycaemia were reported by 39% (n=658) of patients within the previous three months. The risk of any hypoglycaemia was associated with the use of insulin (odds ratio [OR 3.26, 95% CI 2.59-4.09]), and total daily insulin dose (OR 1.04, 95% CI 1.01-1.07 per 10 IU increase). Mean HbA1c had not changed significantly between DiabCare cohorts 2008 and 2013 (p=0.08).

CONCLUSIONS

Despite evidence of improving processes of diabetes care, glycaemic control and the prevalence of many diabetes related complications were unchanged.

摘要

目的

本研究旨在重新评估基于医院的糖尿病护理服务与并发症预防之间的关系。

方法

DiabCare是一项基于医院门诊糖尿病护理的观察性、非干预性横断面研究。

结果

共有1668例患者参与了本研究：平均年龄57.8±11.0岁，糖尿病病程13.0±8.6年，胰岛素治疗病程5.6±5.5年。平均体重为74.3±16.6kg（BMI 29.1±5.8kg/m²）。大多数患者为女性（53.6%），最大的种族群体是马来人（51.3%），其次是印度人（21.9%）和华人（20.1%）。糖化血红蛋白（HbA1c）<6.5%（<42 mmol/mol）和<7.0%（<53 mmol/mol）的患者百分比分别为12.2%和23.8%（平均HbA1c 8.52±2.01% [70±22 mmol/mol]）。使用胰岛素的患者比例为65%，每日总剂量为60±37IU。在过去三个月内，39%（n=658）的患者报告有一次或多次低血糖发作。任何低血糖风险均与胰岛素使用（优势比[OR] 3.26，95%置信区间[CI] 2.59 - 4.09）以及每日胰岛素总剂量（每增加10IU，OR 1.04，95%CI 1.01 - 1.07）相关。2008年和2013年DiabCare队列之间的平均HbA1c没有显著变化（p=0.08）。