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2型糖尿病患者糖化血红蛋白控制与自我管理相关因素的关系研究 总被引:1,自引:0,他引:1
目的了解2型糖尿病患者血糖化血红蛋白(HbA1c)控制水平与自我管理相关因素的关系。方法采用横断面调查的方法,从4个城市15家医院内分泌科门诊连续募集现患病例。由经过统一培训的调查员采用问卷调查的方式收集患者的一般人口学信息、自我管理信息,同时采集患者5μl指尖血送各城市指定医院进行HbA1c检测。运用logistic回归模型探讨自我管理相关因素与患者HbA1c控制水平的关系。结果共收集有效问卷1524份。多因素分析结果显示控制饮食(OR=0.49,95%CI:0.34~0.72),遵从医嘱(OR=0.63,95% CI:0.40~0.98),监测血糖(≤4次/月:OR=0.66,95% CI:0.50~0.87;>4次/月:OR=0.51。95% CI:0.36~0.73),知晓糖尿病相关知识(OR=0.60,95% CI:0.46~0.80)和检测HbA1c(≥3次/年:OR=0.33,95% CI:0.23~0.48;0~3次/年:OR=0.57,95% CI:0.43~0.74)是HbA1c控制的促进因素。结论自我管理有助于2型糖尿病患者的HbA1c控制,建议加强患者的自我管理以促进HbA1c控制。 相似文献
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Associations with low rates of postpartum glucose screening after gestational diabetes among Indigenous and non‐Indigenous Australian women 下载免费PDF全文
Catherine Chamberlain Bronwyn Fredericks Anna McLean Brian Oldenburg Jacqueline Mein Rory Wolfe 《Australian and New Zealand journal of public health》2015,39(1):69-76
Objectives: To explore factors associated with postpartum glucose screening among women with Gestational Diabetes Mellitus (GDM). Methods: A retrospective study using linked records from women with GDM who gave birth at Cairns Hospital in Far North Queensland, Australia, from 1 January 2004 to 31 December 2010. Results: The rates of postpartum Oral Glucose Tolerance Test (OGTT) screening, while having increased significantly among both Indigenous* and non‐Indigenous women from 2004 to 2010 (HR 1.15 per year, 95%CI 1.08–1.22, p<0.0001), remain low, particularly among Indigenous women (10% versus 27%, respectively at six months postpartum). Indigenous women in Cairns had a longer time to postpartum OGTT than Indigenous women in remote areas (HR 0.58, 0.38–0.71, p=0.01). Non‐Indigenous women had a longer time to postpartum OGTT if they: were born in Australia (HR 0.76, 0.59–1.00, 0.05); were aged <25 years (HR 0.45, 0.23–0.89, p=0.02); had parity >5 (HR 0.33, 0.12–0.90, p=0.03); smoked (HR 0.48, 0.31–0.76, p=0.001); and did not breastfeed (HR 0.09, 0.01–0.64, p=0.02). Conclusions: Postpartum diabetes screening rates following GDM in Far North Queensland are low, particularly among Indigenous women, with lower rates seen in the regional centre; and among non‐Indigenous women with indicators of low socioeconomic status. Implications: Strategies are urgently needed to improve postpartum diabetes screening after GDM that reach women most at risk. 相似文献
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Objective: To identify factors predicting suboptimal glycaemic control in rural adults during the initial five years post‐type 2 diabetes diagnosis. Design: Retrospective medical record audit. Quantitative study. Setting: Rural community‐based primary health service, South Gippsland, Victoria, Australia. Participants: Two hundred and seventy‐two de‐identified medical records randomly selected from the type 2 diabetes outpatient database. Main outcome measures: Demographic, biochemical, anthropometric, pharmacological, co‐morbidity and lifestyle data during the first five years post‐diabetes diagnosis were retrospectively collected. Univariate analysis was performed to identify variables associated with poor diabetes control (HbA1c ≥ 7%). Results: Independent predictors of poor glycaemic control in this rural cohort were elevated fasting glucose at diagnosis (odds ratio (OR) 1.97, 95% confidence interval (CI) 1.31–2.97, P < 0.001), weight gain during the initial 2.5 years of diabetes (OR 1.33, 95% CI 1.11–1.59, P < 0.01), excessive body weight at diagnosis (OR 1.07, 95% CI 1.03–1.12, P < 0.001) and younger age at diagnosis (OR 0.94, 95% CI 0.88–1.00, P < 0.05). These variables combined explained 48% of the variation in HbA1c. Gender, body mass index, waist circumference and lifestyle factors at diagnosis were not significant predictors of diabetes control. Conclusions: Young–middle‐aged adults (≤58 years) with elevated fasting glucose (≥9.0 mmol L?1) and excessive body weight (≥93.1 kg) at type 2 diabetes diagnosis and those unable to lose weight early in the course of the disease are more likely to experience a rapid deterioration in glucose control. Rural clinicians should target these individuals for aggressive diabetes management from the time of diagnosis. 相似文献
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ObjectiveTo identify the association between glycemia control with level of diabetes knowledge, diabetes education, and lifestyle variables in patients with type 2 diabetes.DesignCross-sectional analytical study.SiteClinics of the Mexican Institute of Social Security (IMSS), Mexico.ParticipantsPatients with type 2 diabetes.Main measurementsGlycated hemoglobin (HbA1c), glucose, and lipid profile levels were measured from fasting venous blood samples. Assessment of disease knowledge was performed using the Diabetes Knowledge Questionnaire (DKQ-24). Systolic and diastolic blood pressure was measured. Weight and abdominal circumference were measured, as well as body composition using bioimpedance. Sociodemographic, clinical, and lifestyle variables were obtained.ResultsA total of 297 patients were included, sixty-seven percent (67%) were women with a median of six years since the diagnosis of diabetes. Only 7% of patients had adequate diabetes knowledge, and 56% had regular knowledge. Patients with adequate diabetes knowledge had a lower body mass index (p = 0.016), lower percentage of fat (p = 0.008), and lower fat mass (p = 0.018); followed a diet (p = 0.004) and had received diabetes education (p = 0.002), and to obtain information about their illness (p = 0.001). Patients with low levels of diabetes knowledge had a higher risk of HbA1c ≥ 7% (OR: 4.68; 95% CI: 1.48,14.86; p = 0.009), as well as those who did not receive diabetes education (OR: 2.17; 95% CI: 1.21–3.90; p = 0.009) and those who did not follow a diet (OR: 2.37; 95% CI: 1.01,5.55; p = 0.046).ConclusionInadequate knowledge of diabetes, lack of diabetes education, and dietary adherence are associated with poor glycemia control in patients with diabetes. 相似文献
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Michael S. Kramer John Lydon Louise Séguin Lise Goulet Susan R. Kahn Helen McNamara Jacques Genest Shakti Sharma Michael J. Meaney Michael Libman Mourad Dahhou Robert W. Platt 《Paediatric and perinatal epidemiology》2010,24(4):390-397
Kramer MS, Lydon J, Séguin L, Goulet L, Kahn SR, McNamara H, Genest J, Sharma S, Meaney MJ, Libman M, Dahhou M, Platt RW. Non‐stress‐related factors associated with maternal corticotrophin‐releasing hormone (CRH) concentration. Paediatric and Perinatal Epidemiology 2010. During pregnancy, most maternal corticotrophin‐releasing hormone (CRH) is secreted by the placenta, not the hypothalamus. Second trimester maternal CRH concentration is robustly associated with the subsequent risk of preterm birth, and it is often assumed that physiological and/or psychological stress stimulates placental CRH release. Evidence supporting the latter assumption is weak, however, and other factors affecting maternal CRH have received little attention from investigators. We carried out a case–control study nested within a large, multicentre prospective cohort of pregnant women to examine potential ‘upstream’ factors associated with maternal CRH concentration measured at 24–26 weeks of gestation. The predictors studied included maternal age, parity, birthplace (as a proxy for ethnic origin), pre‐pregnancy body mass index, height, smoking, bacterial vaginosis and vaginal fetal fibronectin (FFN) concentration. Women with high (above the median) plasma CRH concentration were significantly less likely to have been born in Sub‐Saharan Africa or the Caribbean, less likely to be overweight or obese, and more likely to be smokers. Associations with maternal birthplace and BMI persisted in logistic regression analyses controlling for potential confounding variables and when restricted to term controls. A strong (but imprecise and statistically non‐significant) association was also observed with high vaginal FFN concentration. Further studies are indicated both in animal models and human populations to better understand the biochemical and physiological pathways to CRH secretion and their aetiological role, if any, in preterm birth. 相似文献
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Country‐of‐birth differences in adverse health behaviours among people with type 2 diabetes 下载免费PDF全文
Seyed Morteza Shamshirgaran Louisa Jorm Hilary Bambrick Annemarie Hennessy 《Australian and New Zealand journal of public health》2015,39(3):250-254
Objective: To identify differences in patterns of adverse health behaviours among people with type 2 diabetes according to country or region of birth. Methods: Population‐based study of 23,112 individuals with type 2 diabetes aged 45 years and older, from New South Wales, Australia. Self‐reported questionnaire data and logistic regression models were used to estimate odds ratios for adverse health behaviours according to country or region of birth, adjusted for confounding factors. Results: People with diabetes born in the Middle East and in the United Kingdom (UK) were more likely to be current smokers than those born in Australian, while those from Asia were less likely to be smokers. Relative to Australian‐born people with diabetes, those born in the Middle East were more likely to have insufficient physical activity, while those born in Oceania, North West Europe and the UK were less likely. People with diabetes from Asia, North Africa, the Middle East and Sub‐Saharan Africa were less likely to consume alcohol than those born in Australia, but people born in the UK were slightly more likely to consume alcohol. People with diabetes born in the UK, Asia, and North Africa were more likely than those born in Australia to have an inadequate intake of fruit and vegetables. Conclusion: Adverse health behaviours among people with type 2 diabetes varied markedly according to country or region of birth. Promoting smoking cessation and increasing physical activity levels among people with diabetes who were born in Middle Eastern countries are clear priorities. 相似文献
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目的 了解南宁市城市和农村2型糖尿病患者血糖控制的影响因素,为开展针对性的干预措施提供科学依据。方法 采用多阶段随机抽样方法,对2018年南宁市1个城区300例及1个县区200例2型糖尿病患者进行问卷调查和血糖检测。采用SPSS 24.0软件进行分析,并利用LASSO回归模型分析糖尿病患者血糖控制影响因素。 结果 城市患者血糖控制达标比例(45.61%)高于农村患者(29.65%),差异有统计学意义(χ2=12.719,P<0.05)。血糖控制达标组每天锻炼身体、门诊随访方式、规律使用降血糖药物、血压控制达标、糖尿病防治知识回答正确>6题的比例均高于不达标组,差异均有统计学意义(P<0.05)。最小绝对值收敛和选择算子回归结果显示:无论是城市还是农村,糖尿病病程≥10年(β分别为0.30、0.07)、一年内吸烟(β分别为0.23、0.27)、不规律使用降糖药物(β分别为0.29、0.36)、糖尿病防治知识回答正确≤6题(β分别为0.21、0.08)均是2型糖尿病患者血糖控制的危险因素,而一年内随访次数<4次(β分别为-0.44、-0.81)是保护因素。除城镇医疗保险外的其他医疗保险、每天检测血糖频率不足1次是城市患者血糖控制的危险因素(β分别为0.14、0.15),但却是农村患者的保护因素(β分别为-0.13、-0.87);初中及以上文化程度是城市患者血糖控制的保护因素(β=-0.22),但却是农村患者的危险因素(β=0.40)。除此之外,城市患者血糖控制的危险因素还包括一年内饮酒(β=0.07);农村患者血糖控制的危险因素还包括已婚(β=0.08),保护因素包括无糖尿病家族史(β=-1.66)。 结论 南宁市2型糖尿病城市患者血糖控制情况优于农村患者,并且城乡患者血糖控制的影响因素不同,应根据城市和农村不同地区采取针对性措施,从而改善患者健康生活方式和血糖控制行为。 相似文献
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Perceptions of general and postpresidential election discrimination are associated with loss of control eating among racially/ethnically diverse young men 下载免费PDF全文
Nichole R. Kelly PhD Tasia M. Smith PhD Gordon C. N. Hall PhD Claire Guidinger MA Gina Williamson BA Elizabeth L. Budd PhD Nicole R. Giuliani PhD 《The International journal of eating disorders》2018,51(1):28-38
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Huy Van Nguyen Thi Hong Ngoc Nguyen 《The International journal of health planning and management》2015,30(3):219-231
In Vietnam, many medicine sellers serving pharmacies and retail outlets do not have adequate professional qualifications, and there has been a limited institutional control. The objective of this cross‐sectional study was to examine the prevalence and determinants of self‐medication among medicine sellers in Hanoi, Vietnam. Although 96.55% of medicine sellers had relatively serious health problems, only 61.21% visited a healthcare facility, though self‐medication was moderately high (approximately 39%). Adopting Andersen's conceptual model, it was identified that medicine sellers who reported higher professional education, had low confidence in healthcare services, had not received any professional in‐service during the prior year, had less serious health problems and who perceived the current costs of healthcare as too high were more likely to report self‐medication. The findings have public health policy implications for these healthcare providers in urban Vietnam and other similar developing countries. Copyright © 2013 John Wiley & Sons, Ltd. 相似文献
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