共查询到20条相似文献，搜索用时 31 毫秒
1.
Siyu Chen Xuhong Hou Yu Sun Gang Hu Xiaoyan Zhou Huijuan Xue Peizhu Chen Jingzhu Wu Yuqian Bao Weiping Jia 《Primary Care Diabetes》2018,12(3):231-237
Aims
To assess whether an integrated hospital-community diabetes management program could improve major cardiovascular risk factor control among patients with diabetes in real-world clinical settings.Methods
985 adults with diabetes in the Shanghai Taopu community health service center were enrolled at baseline and 907 subjects completed the follow-up. The follow-up levels of the metabolic profiles were assessed by their averages during the follow up period.Results
After a mean 7-year follow-up period, heamoglobin A1c, systolic and diastolic blood pressure levels decreased by 0.6%, 5.7 mmHg, and 1.5 mmHg, respectively (all P < 0.001). There was a non-significant difference in low-density lipoprotein cholesterol, while high-density lipoprotein cholesterol increased 1.9 mg/dL and triglycerides decreased 28.3 mg/dL, respectively (all P < 0.001). The percentage of patients with diabetes who met any one of three Chinese Diabetes Society goals (heamoglobin A1c <7.0%, blood pressure <140/80 mmHg, and low-density lipoprotein cholesterol <100 mg/dL) increased from 58.2% to 70.1%. The chronic diabetes complication screening rates (diabetic retinopathy, diabetic neuropathy, diabetic nephropathy) have significantly increased, from almost zero to 12–78%.Conclusions
This long-term program has increased the proportions of attaining major cardiovascular risk factors control goals and diabetic chronic complication screening rates among patients with diabetes. 相似文献2.
3.
Jaya Prasad Tripathy B.M. Prasad 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):251-255
Aim
Diabetes is a growing public health problem in India which is soon going to become the ‘diabetes capital’ of the world. It requires regular care and follow up. We aimed to estimate the household out-of-pocket (OOP) expenditure and catastrophic expenditure due to hospitalization and outpatient care as a result of diabetes.Materials and methods
Secondary analysis of nationally representative data for India collected by National Sample Survey Organization in 2014, reporting on health service utilization and health care related OOP expenditure by income quintiles and by type of health facility (public or private).Results
The median household OOP expenditure from hospitalization due to diabetes was USD 151, and was 3 times higher among the richest quintile compared to the poorest quintile (p < 0.001). There was a significantly higher prevalence (p < 0.001) of catastrophic expenditure among the poorest quintile (36%) compared to the richest (14%). Median private sector OOP hospitalization expenditure was four times higher than the public sector (p < 0.001). Medicines accounted for 41% and 69% of public sector hospitalization and outpatient care respectively. Concentration indices show gross inequity in hospitalization expenditure, prevalence of catastrophic expenditure and utilization of public health facility.Conclusion
Households with diabetic patients incur a high risk of catastrophic expenditure, particularly for those in the lowest income quintiles and those seeking care in the private sector. Increased availability and access to essential drugs and strengthening of public facilities will significantly reduce OOP expenditure. 相似文献4.
Hamideh Lari Rahim Tahmasebi Azita Noroozi 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(1):45-50
Background
By high prevalence of inactivity, particularly in diabetic patients, the need to effective interventions to promote physical activity is essential. The aim of this study was to determine the effects of education based on health promotion model (HPM) through multimedia on the physical activity in diabetic patients.Method
In this quasi-experimental study, 76 patients with type II diabetes were evaluated (40 patents in intervention group and 36 patients in control group). The intervention group members and a friend or a family member, that could be supportive in physical activity, received teaching CD based on health promotion model. Both group members at the beginning of the study, two weeks and three months after the training, completed questionnaires. After data collection, statistical analysis was conducted using independent T-test, chi-square test, and repeated measurement of ANOVA.Results
Finding showed that self-efficacy (P < 0.001), health status (p = 0.032), benefits (P < 0.001) and friends support in physical activity (P < 0.001) were perceived to be higher, and barrier of physical activity (P < 0.001) was perceived to be lower in multimedia group compared to control group 3 months after training. There was a significant difference in average of metabolic equivalent of task (MET) between two groups after the intervention (P < 0.001).Conclusion
Planning of education based on the HPM and implementation through multimedia can change belief about physical activity and increase participation in physical activity. 相似文献5.
Eman F El-Sayed Heitham Awadalla Sufian K Noor Wadie M Elmadhoun Amel A Sulaiman Ahmed O Almobarak Mohamed H Ahmed 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(3):245-250
Aim
The aim of this study was to assess the level of sugar intake among Sudanese individuals.Materials and methods
A cross-sectional study with 323 participants. Respondents were grouped by the total intake of added sugars into two groups, one group with sugar intake more than 200 calories per day and other group with sugar intake less than 200 calories per day. Demographic data were collected with anthropometric measurements like body mass index (BMI) and waist circumference. Chi square, T-Tests and stepwise logistic regression were used (a p-value <0.05 was considered significant).Results
High sugar intake was noted among 74.6% participants and among overweight, normal weight, followed by obese (p < 0.015) and then individuals with diabetes and hypertension (p < 0.000 and 0.038 respectively).High sugar intake was also associated with abdominal obesity (p < 0.016), mean age of 33 years old (p < 0.00) and being married and single(p < 0.003). Stepwise logistic regression showed diabetes and BMI < 25 were absolute predictors for sugar consumption with p value of 0.001 and 0.039 respectively. Individuals with diabetes have more than five times probability to consume large amount of sugar (Odd ratio 5.6), while those with BMI < 25 have two times risk of consuming more sugar compared to those with BMI > 25 group (Odd ratio 2.1).Conclusion
A large percentage of Sudanese population uses a high amount of sugar. High sugar intake was associated with normal weight, overweight, abdominal obesity, diabetes and hypertension. Absolute predictors of high sugar intake were diabetes and normal body weight. 相似文献6.
Leonardo Lorente María M. Martín Pedro Abreu-González Antonia Pérez-Cejas Raquel Ortiz López José Ferreres Jordi Solé-Violán Lorenzo Labarta César Díaz Celina Llanos Alejandro Jiménez 《Enfermedades infecciosas y microbiología clínica》2018,36(9):544-549
Objective
Higher serum melatonin levels have previously been found in patients with severe sepsis who died within 30 days of diagnosis than in survivors. The objective of our study were to determine whether serum melatonin levels during the first seven days of severe sepsis diagnosis could be associated with sepsis severity and mortality.Methods
Multicentre study in eight Spanish Intensive Care Units which enrolled 308 patients with severe sepsis. We determined serum levels of melatonin, malondialdehyde (as biomarker of lipid peroxidation) and tumor necrosis factor-alpha at days 1, 4 and 8 of severe sepsis diagnosis. The study's primary endpoint was 30-day mortality.Results
A total of 103 patients had died and 205 survived at 30 days of severe sepsis diagnosis, with the non-survivors presenting higher serum melatonin levels at days 1 (p < 0.001), 4 (p < 0.001) and 8 (p < 0.001) of severe sepsis diagnosis than the survivor patient group. The multiple logistic regression analysis found that serum melatonin levels at days 1, 4 and 8 of severe sepsis diagnosis (p < 0.001, p = 0.01 and p = 0.001, respectively) were associated with mortality adjusted for age, serum lactic acid, SOFA score and diabetes mellitus.Conclusions
The novel and more interesting findings of our study were that serum melatonin levels during the first seven days of severe sepsis diagnosis are associated with sepsis severity and mortality. 相似文献7.
Vinni Faber Rasmussen Esben Thyssen Vestergaard Ole Hejlesen Camilla Urup Noe Andersson Simon Lebech Cichosz 《Primary Care Diabetes》2018,12(5):453-459
Aim
This study investigates the prevalence of smell and taste impairment in adults with diabetes and potential risk factors for sense deterioration and its influence of daily food intake.Methods
Data from the NHANES 2013-2014 were analyzed. Smell impairment was defined as failing to identify?≥3 of 8 odors in NHANES Pocket Smell Test. Taste impairment was defined as being unable to identify quinine or NaCl in NHANES Tongue Tip and Whole-mouth Test.Results
A total of 3204 people (428 patients with diabetes, 2776 controls) were suitable to be included. The prevalence of smell impairment in patients with diabetes was higher compared to the controls: 22% versus 15% (p < 0.001). The difference prevailed after adjustment for age, BMI, alcohol misuse and smoking status. Taste was not impaired in patients with diabetes (p = 0.29). Patients with diabetes and smell impairment had a lower daily calorie intake compared to patients with diabetes and normal smell function. The duration of diabetes, diabetic complications and other potential risk factors were not associated with smell dysfunction.Conclusions
Smell dysfunction appears with a higher prevalence in patients with diabetes, and this seems to negatively affect daily food intake. 相似文献8.
Caroline King Sidney Atwood Chris Brown Adrianne Katrina Nelson Mia Lozada Jennie Wei Maricruz Merino Cameron Curley Olivia Muskett Samantha Sabo Vikas Gampa John Orav Sonya Shin 《Primary Care Diabetes》2018,12(3):212-217
Objectives
To evaluate the role of primary care healthcare delivery on survival for American Indian patients with diabetes in the southwest United States.Methods
Data from patients with diabetes admitted to Gallup Indian Medical Center between 2009 and 2016 were analyzed using a log-rank test and Cox Proportional Hazards analyses.Results
Of the 2661 patients included in analysis, 286 patients died during the study period. Having visited a primary care provider in the year prior to first admission of the study period was protective against all-cause mortality in unadjusted analysis (HR (95% CI) = 0.47 (0.31, 0.73)), and after adjustment. The log-rank test indicated there is a significant difference in overall survival by primary care engagement history prior to admission (p < 0.001). The median survival time for patients who had seen a primary care provider was 2322 days versus 2158 days for those who had not seen a primary care provider.Conclusions
Compared with those who did not see a primary care provider in the year prior to admission, having seen a primary care provider was associated with improved survival after admission. 相似文献9.
Yen-wei Pai Ching-Heng Lin I-Te Lee Ming-Hong Chang 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2018,12(2):111-116
Aims
To investigate the prevalence and risk factors for diabetic peripheral neuropathy with or without neuropathic pain in Taiwanese.Methods
A cross-sectional, hospital-based observational study was conducted. We enrolled 2837 adults with type 2 diabetes mellitus. Diabetic peripheral neuropathy with or without pain were diagnosed using 2 validated screening tools, namely the Michigan Neuropathy Screening Instrument and Douleur Neuropathique 4 questionnaire.Results
In our sample, 2233 participants had no neuropathy, 476 had diabetic peripheral neuropathy without pain, and 128 had diabetic peripheral neuropathy with neuropathic pain, representing an overall diabetic peripheral neuropathy prevalence of 21.3%, and the prevalence of neuropathic pain in diabetic peripheral neuropathy was 21.2%. Multivariate analysis revealed that older age (P < 0.001), treatment with insulin (P = 0.004), microalbuminuria (P = 0.001) or overt proteinuria (P < 0.001) were independently associated with diabetic peripheral neuropathy, whereas older age (P < 0.001), elevated glycated haemoglobin (P = 0.011), lower high-density lipoprotein cholesterol (P = 0.033), and overt proteinuria (P < 0.001) were independently associated with diabetic peripheral neuropathy with neuropathic pain.Conclusions
During clinical visits involving biochemical studies, the risk for diabetic peripheral neuropathy with neuropathic pain should be considered for people with older age, elevated glycated haemoglobin, low high-density lipoprotein cholesterol and overt proteinuria, with particular attention given to increased levels of albuminuria while concerning neuropathic pain. 相似文献10.
T.-T. Li A.-P. Wang J.-X. Lu M.-Y. Chen C.-C. Zhao Z.-H. Tang L.-X. Li W.-P. Jia 《Diabetes & metabolism》2018,44(5):437-443
Aim
As the prevalence and clinical characteristics of non-alcoholic fatty liver disease (NAFLD) are still unknown in ketosis-onset diabetes, the present study compared the characteristics of NAFLD in type 1 diabetes (T1D), ketosis-onset and non-ketotic type 2 diabetes (T2D) patients.Methods
This cross-sectional study was performed with newly diagnosed Chinese patients with diabetes, including 39 T1D, 165 ketosis-onset and 173 non-ketotic T2D, with 30 non-diabetics included as controls. NAFLD was determined by hepatic ultrasonography, then its clinical features were analyzed and its associated risk factors evaluated.Results
NAFLD prevalence in patients with ketosis-onset diabetes (61.8%) was significantly higher than in controls (23.3%; P = 0.003) and in T1D patients (15.4%; P < 0.001). However, there was no difference in prevalence between ketosis-onset and non-ketotic T2D patients (52.6%; P = 0.229), although BMI and alanine aminotransferase (ALT) proved to be independent risk factors for the presence of NAFLD in both these groups whereas, in T1D patients, serum uric acid levels were independent risk factors.Conclusion
NAFLD prevalence and risk factors in ketosis-onset diabetes were similar to those in non-ketotic T2D, but different from those in T1D. These data provide further evidence that ketosis-onset diabetes should be classified as a subtype of T2D rather than idiopathic T1D. 相似文献11.
Aims
Vitamin D is associated with diabetes mellitus (DM) occurrence by affecting insulin secretion and resistance. However, variations exist due to differences in vitamin D sensitivity among individuals. We investigate the relationship between serum 25-hydroxyvitamin D [25(OH)D] status and various indices of DM in a Korean population without DM.Methods
Large-scaled population-based analysis was conducted from the Korea National Health and Nutrition Examination Survey data (2010–2012) were analyzed. Adult survey participants >20 years without diabetes (n = 15,169) were included.Results
The mean 25(OH)D levels were lower in females, subjects aged 20–39 years, and subjects with body mass index <21.1 kg/m2 and less physical activity (p < 0.001). Further, the mean 25(OH)D levels tended to be lower in subjects with FBG >126 mg/dL. After adjustment for potential confounders, 25(OH)D was not correlated with FBG (p = 0.925) or HbA1c (p = 0.336); however, fasting insulin (β = ?0.072, p = 0.011) and homeostasis model assessment of β-cell function (β = ?0.007, p < 0.001) showed significant negative correlations with 25(OH)D levels.Conclusion
Although 25(OH)D status was not significantly associated with FBG or HbA1c, low 25(OH)D levels were associated with compensative insulin increase and ongoing increase in insulin resistance. Thus, vitamin D deficiency is assumed to influence DM occurrence. 相似文献12.
Francesco Fici Elif Ali Bakir Sengul Beyaz Wim Makel Nicolas Roberto Robles 《Primary Care Diabetes》2018,12(6):558-564
Background
Albuminuria is an early marker of kidney disease in patients with diabetes and/or hypertension undetected or untreated albuminuria is a leading cause of chronic kidney disease and cardiovascular events, The purpose of the present survey was to assess the prevalence of albuminuria in patients with diabetes and hypertension, treated with a combinations of renin angiotensin aldosterone system inhibitors and dihydropyridine calcium channel blockers.Methods
The survey was performed in 105 Primary Care Units in Turkey and involved outpatients, routinely visited by either a specialist or a non-specialist physician.Albuminuria was evaluated in a spot morning urine sample, as albumin–creatinine ratio, using the Multistic-Clinitek-device analyzer (Siemens), that has a strong correlation with 24-h urinary albumin excretion. Microalbuminuria was defined as a loss of 3.4–33.9 mg albumin/mmol creatinine and macroalbuminuria as a loss of >33.9 mg albumin/mmol creatinine. Diabetes was assessed through documented blood glucose concentration or use antidiabetic drugs, whereas hypertension through blood pressure measurement and current antihypertensive treatment.Results
The survey enrolled 1708 subjects with a prevalence of type 2 diabetes (87.6%). Albuminuria was detected in 52.0% of patients. Blood pressure was controlled in 37.0% and diabetes in 56.7%. The risk of albuminuria was significantly high in patients with uncontrolled diabetes (p < 0.001) and blood pressure (p = 0.009).Conclusions
In a large cohort of treated hypertensive patients with diabetes, albuminuria was present in about 50% and was correlated with poor diabetes and blood pressure control. Systematic screening of albuminuria, particularly in Primary Care, is an important tool for the early diagnosis of nephropathy. 相似文献13.
N. Behniafard A.A. Amirzargar M. Gharagozlou F. Delavari S. Hosseinverdi S. Sotoudeh E. Farhadi M. Mahmoudi M. Khaledi Z.G. Moghaddam A. Aghamohammadi N. Rezaei 《Allergologia et immunopathologia》2018,46(2):155-159
Background
Atopic dermatitis is an inflammatory skin disease in which both genetic and environmental factors interact to determine the susceptibility and severity of the disease.Objective
The aim of this study was to determine the association between atopic dermatitis and IL-10 and TGF-β1 gene polymorphisms.Methods
The allele and genotype frequencies of genes encoding for IL-10 and TGF-β1 were investigated in 89 patients with atopic dermatitis in comparison with 138 in the control group using the PCR-SSP method.Results
A significant increase was found in the frequency of the TGF-β1 codon 10/C allele among patients (p < 0.001, OR = 6.77), whereas a significant decrease was observed in the frequency of the T allele at the same position (p < 0.001, OR = 0.14). The frequency of the TGF-β1 codon 25/G allele in the control group was significantly higher than among patients (p < 0.001, OR = 0.08). A significant positive correlation was seen between CC (p < 0.001, OR = 15.10) and CG (p < 0.001) genotypes and AD at codons 10 and 25, respectively. The most frequent haplotypes among patients was TGF-β1 CG which was significantly higher than in the control subjects (50% in patients vs. 39.9% in controls, p = 0.042). A significant increase was found in the frequency of TGF-β CC (36% in patients vs. 7.6% in controls, p < 0.001) and TC (14% in patients vs. 0% in controls, p < 0.001) haplotypes among patients compared to controls. By contrast, the TGF-β1 TG haplotype was significantly lower in patients than controls (0% in patients vs. 52.5% in controls, p < 0.001). There were no significant differences in the frequency of alleles, genotypes and haplotypes of the IL-10 gene.Conclusions
We found a strong association between the polymorphisms of the TGF-β1 gene at codon 10 and codon 25 positions and atopic dermatitis. 相似文献14.
Amani Al-Rawashdeh Violet Kasabri Nailya Bulatova Amal Akour Ayman Zayed Munther Momani Nahla Khawaja Haider Bustanji Dana Hyasat 《Diabetes & Metabolic Syndrome: Clinical Research & Reviews》2017,11(1):59-67
Background
Oxytocin (OXT) is a neurohypophyseal hormone that has been recently shown to possess a number of beneficial effects in diabetes and obesity. Betatrophin is a protein expressed in fat and liver that regulates lipid metabolism and promotes pancreatic β-cell proliferation. It is not investigated yet whether OXT and betatrophin levels correlate in metabolic syndrome (MS) or diabetes patients.Methods
The aim was to assess correlations between plasma betatrophin and OXT levels in MS-diabetic or prediabetic (N = 89) as compared to MS-non-diabetic (N = 69) patients. Competitive binding ELISA was used to evaluate betatrophin and OXT plasma concentrations. Correlations of the above biomarkers and patient clinical characteristics were also detected.Results
As compared to the control MS participants (0.32 ± 0.25 ng/mL); betatrophin plasma levels were increased (P < 0.001) in the MS-pre/T2DM patients (1.23 ± 0.68 ng/mL). On the contrary, OXT concentrations were decreased (P < 0.001) in the MS-pre/T2DM patients (1222.46 ± 514.55 pg/mL) as compared to the MS control subjects (2323.42 ± 848.68 pg/mL). OXT concentration correlated negatively (r = ?0.492, P < 0.001), while HbA1c and FPG correlated positively with betatrophin plasma levels (P < 0.001), but were inversely correlated with OXT levels (P < 0.001) in the total sample.Conclusion
Betatrophin levels are increased, while OXT levels are decreased in MS-pre/T2DM. We found an inverse correlation between the levels of the two biomarkers in addition to correlation between their levels and the degree of glycemic control. 相似文献15.
Kurt Azzopardi Alfred Gatt Nachiappan Chockalingam Cynthia Formosa 《Primary Care Diabetes》2018,12(2):111-115
Aim
Diabetic peripheral neuropathy is an important complication and contributes to the morbidity of diabetes mellitus. Evidence indicates early detection of diabetic peripheral neuropathy results in fewer foot ulcers and amputations. The aim of this study was to compare different screening modalities in the detection of diabetic peripheral neuropathy in a primary care setting.Method
A prospective non-experimental comparative multi-centre cross sectional study was conducted in various Primary Health Centres. One hundred participants living with Type 2 diabetes for at least 10 years were recruited using a convenience sampling method. The Vibratip, 128 Hz tuning fork and neurothesiometer were compared in the detection of vibration perception.Results
This study showed different results of diabetic peripheral neuropathy screening tests, even in the same group of participants. This study has shown that the percentage of participants who did not perceive vibrations was highest when using the VibraTip (28.5%). This was followed by the neurothesiometer (21%) and the 128 Hz tuning fork (12%) (p < 0.001).Conclusion
Correct diagnosis and treatment of neuropathy in patients with diabetes is crucial. This study demonstrates that some instruments are more sensitive to vibration perception than others. We recommend that different modalities should be used in patients with diabetes and when results do not concur, further neurological evaluation should be performed. This would significantly reduce the proportion of patients with diabetes who would be falsely identified as having no peripheral neuropathy and subsequently denied the benefit of beneficial and effective secondary risk factor control. 相似文献16.
Hayford Mawuli Avedzi Nonsikelelo Mathe Kate Storey Jeffrey Allen Johnson Steven Thomas Johnson 《Primary Care Diabetes》2018,12(1):71-79
Aim
We examined self-reported dietary behaviours and actual food intakes among adult men and women with type 2 diabetes participating in Alberta’s Caring for Diabetes (ABCD) Study.Methods
Participants completed 3-day food records and questions about glycemic index (GI) concept knowledge and dietary behaviours. Daily average GI and glycemic load (GL) were calculated for all carbohydrates consumed. Dietary intake was analyzed using ESHA FoodPro (version 10.13.1). Sex differences in nutrient intakes were explored across categories of GI knowledge and dietary practices.Results
Participants (N = 170) mean (SD) age 65.8 (9.6) years were 46.5% women, 90.6% Caucasian with a mean BMI of 31.3 (7.0) kg/m2 and diabetes duration of 13.4 (8.6) years. Overall, 60% of men versus 40% of women consumed carbohydrates in quantities below Acceptable Macronutrient Distribution Ranges (AMDR). About 80% of men versus 90% of women consumed proteins above AMDR whereas 60% versus 65% of women consumed fats above AMDR. Fibre intake among men was lower than recommended (p < 0.01). Men who reported having knowledge of the GI-concept also reported lower GI intake versus men who did not (p = 0.03).Conclusion
Sex differences exist in low-GI diabetes self-care dietary behaviours among adults with type 2 diabetes participating in this study. Gender-sensitive approaches for enhancing diabetes self-care low-GI dietary behaviour should be explored. 相似文献17.
Sharon H. Saydah Edward W. Gregg Henry S. Kahn Mohammed K. Ali 《Primary Care Diabetes》2018,12(1):3-12
Aims
Determine the mortality experience among adults with diabetes in meeting and not meeting less intense control for glycated hemoglobin (HbA1c), blood pressure (BP), and cholesterol.Methods
National Health and Nutrition Examination Survey 1999–2010 participants with self-report of diagnosed diabetes (N = 3335), measured HbA1c, BP and non-HDL cholesterol were linked to the National Death Index through December 31, 2011. Proportional hazards models were used to estimate hazard ratios (HR) of meeting HbA1c < 9% and BP < 160/110, and non-HDL cholesterol < 190 mg/dL. Models used age as the time scale and adjusted for demographics (sex, race/ethnicity, education), diabetes duration, history of cardiovascular and chronic kidney disease, and treatments for elevated glucose, BP, and cholesterol.Results
Over a mean 5.4 person-years of follow-up, participants meeting all less intense control had a 37% lower mortality (HR = 0.63, 95% CI 0.54, 0.74) relative to those who did not meet the goals. Of approximately 306,000 deaths per year that occur among Americans with diabetes, we estimate 39,400 might have been averted by improving the care of those who have not met these less intense control goals.Conclusions
Meeting the less intense control goals is associated with 37% reduction in mortality and could lead to 39,400 fewer deaths per year. 相似文献18.
Rebecka Husdal Andreas Rosenblad Janeth Leksell Björn Eliasson Stefan Jansson Lars Jerdén Jan Stålhammar Lars Steen Thorne Wallman Ann-Marie Svensson Eva Thors Adolfsson 《Primary Care Diabetes》2018,12(1):23-33
Aims
To examine the association between personnel resources and organisational features of primary health care centres (PHCCs) and individual HbA1c level in people with Type 2 diabetes mellitus (T2DM).Methods
People with T2DM attending 846 PHCCs (n = 230 958) were included in this cross-sectional study based on PHCC-level data from a questionnaire sent to PHCCs in 2013 and individual-level clinical data from 2013 for people with T2DM reported in the Swedish National Diabetes Register, linked to individual-level data on socio-economic status and comorbidities. Data were analysed using a generalized estimating equations linear regression models.Results
After adjusting for PHCC- and individual-level confounding factors, personnel resources associated with lower individual HbA1c level were mean credits of diabetes-specific education among registered nurses (RNs) (?0.02 mmol/mol for each additional credit; P < 0.001) and length of regular visits to RNs (?0.19 mmol/mol for each additional 15 min; P < 0.001). Organisational features associated with HbA1c level were having a diabetes team (?0.18 mmol/mol; P < 0.01) and providing group education (?0.20 mmol/mol; P < 0.01).Conclusions
In this large sample, PHCC personnel resources and organisational features were associated with lower HbA1c level in people with T2DM. 相似文献19.
Andrii Dudnyk Svitlana Blyzniuk Oleksandr Pavel’chuk Olena Zakharchenko Dmytro Butov Sergiі Zaіkov 《The Indian journal of tuberculosis》2018,65(1):63-69
Tuberculosis (TB) may have a similar spirometry findings as a chronic obstructive pulmonary disease but the prevalence of TB-induced airflow obstruction (AO) is still unknown.
Objectives
To measure frequency of AO in new TB cases at the beginning of treatment and to evaluate factors associated with obstructive abnormalities following TB diagnosis.Materials and Methods
317 patients that have no history of prior AO were recruited into the study with a median age of 39.0 years (IQR, 30.0–49.0). AO was defined using the FEV1/F(VC) < LLN.Results
AO was detected in 29.97% (95/317) new TB cases. These patients had a more severe clinical manifestation of TB with a greater likelihood of cough, OR = 5.47 (95%CI 1.90–15.70) and wheezing, OR = 10.51 (95%CI 5.72–19.27), p < 0.001. The frequency of AO was positively associated with bronchoscopic evidence of narrowing of the main airways. Furthermore, from multiple logistic regression analysis we would assume that higher FEV1 value in TB patients with AO was related to greater BMI and inversely associated with older age, female sex and radiographic extent (p < 0.05).Conclusions
Obstructive pattern on spirometry frequently occurs in new TB cases without previously detected AO. This category of patients should be targeted for detailed follow-up, particularly, in high TB burden countries. 相似文献20.
Ken Yan Thong Mahender Yadagiri Dennis Joseph Barnes David Stuart Morris Tahseen Ahmad Chowdhury Ling Ling Chuah Anthony Michael Robinson Stephen Charles Bain Karen Ann Adamson Robert Elford John Ryder 《Primary Care Diabetes》2018,12(1):45-50