Dyslipidemia and its associated factors in patients with type 2 diabetes mellitus

Journal of Public Health - Dyslipidemia is a major risk factor known to be associated with diabetes and cardiovascular diseases. This study determined the frequency of lipid abnormalities among...     

Immunogenetic factors associated with type 1 diabetes mellitus

Type 1 diabetes mellitus has been considered an organ-specific autoimmune disease derived from the selective destruction of pancreatic beta cells. It presents a complex pathogenesis, involving the participation of several factors, including the immunogenetic susceptibility with strong association to histocompatibility genes (HLA), environmental events and autoimmune response with the presence of autoantibodies and/or autoreactive lymphocytes, culminating in metabolic abnormalities. In this study, the literature review describes mechanisms through which some factors cause susceptibility to its appearance and, additionally, prediction innovations regarding this disorder, which will certainly contribute to nursing care for patients with type 1 diabetes.     

精神分裂症合并糖尿病医院感染及护理干预对策分析

目的探究对精神分裂症合并糖尿病患者采取综合护理干预后的护理效果,为精神分裂症合并糖尿病患者的临床治疗提供依据。方法选取医院2015年7月-2016年7月收治的精神分裂症合并糖尿病患者80例作为研究对象,其中2015年7-12月患者采用常规护理,2016年1-7月患者采取综合护理措施,对患者综合护理措施实施前后生活质量以及心理状况进行评价,分析医院感染患者病原菌构成情况。结果患者在经过综合护理后,SAS评分与SDS评分均低于综合护理前(P0.05);患者在经过综合护理干预后,躯体疼痛、社会功能,生理功能、情感职能以及总体健康各项指标评分均高于护理前(P0.05);80例患者在综合护理前23例患者出现感染,综合护理后5例患者出现感染,两组比较差异有统计学意义(χ2=5.169,P=0.036);28例感染患者临床标本中共分离出病原菌45株,其中革兰阳性菌16株,占35.5%,革兰阴性菌27株,占60.0%,真菌2株,占4.4%;导致患者感染的病原菌主要为肺炎克雷伯菌和链球菌属,分别占28.9%和24.4%。结论导致精神分裂症合并糖尿病患者出现医院感染的因素较多,因此在对患者进行护理的过程中,应注重采用综合的护理措施,预防患者医院感染的发生。     

糖尿病患者饮食治疗依从性及影响因素分析

目的了解糖尿病患者饮食治疗依从现状及影响因素,为糖尿病综合防治提供依据和科学指导。方法以270例糖尿病患者为调查对象,采用自行设计的调查表对糖尿病患者饮食治疗依从情况进行调查。结果270例患者中依从性好的有24例,占8.89%,中等的有49例,占18.11%,差的有197例,占73.00%;糖尿病饮食治疗相关知识调查中掌握程度好的有76例,占28.10%,中等的有102例,占37.83%,差的有92例,占34.07%;糖尿病患者依从性单因素及多因素分析结果显示,年龄、职业、文化程度、经济收入是依从性的影响因素(P<0.05)。结论糖尿病患者饮食治疗依从现状及饮食治疗知识掌握情况不容乐观,需进行广泛、深入、有效的糖尿病健康教育。     

Risk factors in patients with type 2 diabetes mellitus

This study was carried out to evaluate the risk factors of type 2 diabetic patients through sociodemographic data, habits of health, anthropometric and biochemist profiles, assisted at a basic public health care unit in Maringá, Paraná. Sixty-six patients, 56 women aged over than 50 years-old were interviewed. High prevalence factors for cardiovascular risk were observed, such as: overweight and obesity, hypertension, dyslipidemia, sedentariness and inadequate diet. Data suggested the need for multidisciplinary intervention programs in health care units associated to educative programs, adjusted diet intake and regular physical activity for these diabetic patients.     

妊娠期糖尿病患者产后糖代谢异常转归影响因素分析

目的探讨妊娠期糖尿病(GDM)患者产后糖代谢异常(AGM)转归及其影响因素。方法选择2019年1月至12月,于四川大学华西第二医院孕期被诊断为GDM,并于产后4~12周进行75 g口服葡萄糖耐量试验(OGTT)筛查的1175例单胎妊娠产妇为研究对象。根据其产后糖代谢是否正常,将其分为研究组(n=361,产后AGM者)与对照组(n=814,产后糖代谢正常者)。采用回顾性分析方法,收集受试者一般临床资料及孕期与产后4~12周75 g OGTT结果等,并采用成组t检验或χ^(2)检验进行统计学分析。对GDM患者产后AGM转归相关影响因素进行单因素分析与多因素非条件logistic回归分析,探讨其AGM转归的独立影响因素。本研究遵循的程序符合病例收集医院伦理委员会制定的伦理学标准,得到该伦理委员会批准[审批文号:医学科研2021伦审批第(181)号]。结果①24~28孕周时,1175例GDM患者75 g OGTT结果提示,空腹血糖(FPG)及OGTT 1、2 h血糖指标中,1、2、3项升高者分别为639例(54.4%)、373例(31.7%)与163例(13.9%)。②产后4~12周时,1175例GDM患者75 g OGTT结果提示,产后糖代谢正常者为814例(69.3%),AGM为361例(30.7%),包括空腹血糖受损(IFG)为19例(1.6%),糖耐量受损(IGT)为294例(25.0%),IFG+IGT为23例(2.0%),疑似2型糖尿病(T2DM)患者为25例(2.1%)。③产后AGM转归影响因素的单因素分析结果显示,研究组GDM患者年龄、糖尿病家族史发生率,24~28孕周OGTT 1、2 h血糖值,以及2项血糖指标(OGTT 1、2 h血糖)均升高与3项血糖指标(FPG及OGTT1、2 h血糖)均升高者所占比例,均显著高于对照组,而研究组仅1项血糖指标(FPG或OGTT 1 h血糖)升高者所占比例,则显著低于对照组,2组比较,差异均有统计学意义(P<0.05)。④多因素非条件logistic回归分析结果:模型1将受试者年龄、糖尿病家族史及24~28孕周OGTT 1、2 h血糖值进行多因素logistic回归分析结果显示,糖尿病家族史及24~28孕周OGTT 1、2 h血糖值,均为GDM患者产后AGM转归的独立危险因素(OR=1.693、1.205、1.355,95%CI:1.208~2.373、1.088~1.335、1.204~1.524,P=0.002、<0.001、<0.001)。模型2将受试者年龄、糖尿病家族史、24~28孕周OGTT血糖指标升高项目进行多因素logistic回归分析结果显示,糖尿病家族史及24~28孕周OGTT 2项血糖指标(OGTT 1、2 h血糖)升高与3项血糖指标均升高,均为GDM患者产后AGM转归独立危险因素(OR=1.668、1.421、1.747,95%CI:1.192~2.333、1.035~1.952、1.195~2.553,P=0.003、0.030、0.004);24~28孕周仅FPG或OGTT 1 h血糖升高为其独立保护因素(OR=0.401、0.646,95%CI:0.240~0.670、0.418~0.997,P<0.001、=0.048)。结论对于GDM患者产后AGM转归,临床应关注其年龄、糖尿病家族史、孕期OGTT结果等指标。对GDM高危人群进行上述指标持续监测与规范干预,是健全GDM孕前-孕期-产后全程管理的重要环节。     

反复住院2型糖尿病患者健康素养现状及影响因素分析

目的 通过调查分析反复住院2型糖尿病患者的健康素养现状及影响因素,为糖尿病的防治提供参考。方法 采用便利抽样法,于2020年6-10月对某市3所313例住院糖尿病患者采用一般资料调查表、慢性病病人健康素养量表、糖尿病授权简化量表、糖尿病自我管理简化量表进行问卷调查。一般资料采用t检验和方差分析,影响因素分析采用多元线性回归。结果 糖尿病患者的健康素养得分为（93.91±9.08）分,健康素养的具备率为31.95%。结果显示,文化程度（β=0.258, t=3.652, P<0.001）、授权（β=0.233,t=4.547,P<0.001）、户籍（β=0.211, t=3.167, P=0.002）、住院次数（β=-0.167, t=-2.813,P=0.005）、年龄（β=-0.336, t=-6.571, P<0.001）、经济负担（β=-0.175,t=-2.651, P=0.008）以及自我管理能力（β=0.153,t=2.936, P=0.004）对反复住院患者的健康素养产生影响。结论 反复住院的2型糖尿病患者的健康素养低下,卫生保健人员需要根据患者的不同情况制定个体化干预,大力开展糖尿病专科教育和科普活动,提高T2DM患者的健康素养,降低住院率。     

精神分裂症住院患者并发糖尿病的危险因素研究

目的探讨精神分裂症患者伴发糖尿病的可评估性危险因素。方法回顾性调查符合CCMD-3诊断标准的住院精神分裂症患者中的糖尿病发病情况以及抗精神病药物的使用情况等相关因素,并观察体重、血糖和血脂的变化。结果在230例精神分裂症患者中,并发糖尿病者为22例,其发生与患者年龄、病程、使用抗精神病药物以及体重、血脂和阳性糖尿病家族史有相关性。结论精神病人群,年龄较大、病程较长以及长期使用抗精神病药物均可增加糖尿病的发生率。     

Insulin adherence and the associated factors among patients with type 2 diabetes mellitus at the Hospital Queen Elizabeth II,Sabah

Journal of Public Health - The purposes of this study were to: (a) determine the insulin adherence rate and reasons for non-adherence among patients with T2DM, (b) determine the relationship...     

Social representations associated with tube feeding among adult hospitalized patients

This study aimed to identify and understand adult patients' representations on tube feeding. Data were collected through interviews with sixteen patients who were using feeding tubes, which were analyzed through discourse analysis and Social Representation Theory. We identified a sequence in which representations are reorganized and redefined through experience, in order to turn this treatment tolerable. This sequence begins when patients face the need of a feeding tube, followed by the experience of its use and finally, when deciding about continuing its use or not, when going home. Some representations contribute to treatment adherence and others to its rejection. Getting to know positive and negative ideas about this treatment makes it possible to approach these patients in a more direct way, with a view to better adherence and satisfaction.     

Cross-sectional analysis of factors associated with prior contraceptive use among hospitalized obstetric patients in Kabul, Afghanistan

OBJECTIVE: This study was conducted to assess prevalence and correlates of prior contraceptive use among hospitalized obstetric patients in Kabul, Afghanistan. STUDY DESIGN: Medically eligible (e.g., conditions not requiring urgent medical attention, such as eclampsia, or not imminently delivering [dilation > or =8 cm]) obstetric patients admitted to three Kabul public hospitals were consecutively enrolled in this cross-sectional study. An interviewer-administered questionnaire assessed demographic information, health utilization history, including prior contraceptive use, and intent to use contraception. Correlates of prior contraceptive use were determined with logistic regression. RESULTS: Of 4452 participants, the mean age was 25.7 years (SD, +/-5.7 years), 66.4% reported pregnancy before the presenting gestation, 88.4% had > or =1 prenatal care visit and 82.4% reported the current pregnancy was desired. Most (67.4%) had no formal education. One fifth (22.8%) reported using contraception before this pregnancy. Among women with any pregnancy before the current gestation (98.6% of prior users), prior contraceptive use was independently associated with having lived outside Afghanistan in the last 5 years (adjusted odds ratio [AOR], 1.35; 95% confidence interval [CI], 1.12-1.63), having a skilled attendant at the last birth (AOR, 1.35; 95% CI, 1.07-1.71), having a greater number of living children (AOR, 1.30; 95% CI, 1.20-1.41), longer mean birth interval (years) (AOR, 1.21; 95% CI, 1.11-1.38) and higher educational level (AOR, 1.16; 95% CI, 1.09-1.22). Immediate desire for another pregnancy and spousal disapproval were the most common reasons for not utilizing contraception. CONCLUSION: Prior contraceptive use is low among the women in Kabul, Afghanistan, particularly for younger less educated women. Programming in Kabul to strengthen postpartum contraceptive counseling should address barriers to contraceptive use, including immediate desire for pregnancy and spousal attitudes.     

糖尿病合并脑梗死的相关因素分析

目的探讨糖尿病合并脑梗死的相关因素。方法选择2006年6月—2014年11月收治的糖尿病合并脑梗死患者共76例作为观察组,选择同期糖尿病无并发脑血管病患者60例作为对照组。收集患者的病史、临床和实验室检查资料,其中检查项目包含入院时的SBP、DBP,血液生化指标含FBG、Hb A1c、TG、TC、HDL-C、LDL-C。计量资料采用t检验,P0.05为差异有统计学意义。结果观察组糖尿病病程、SBP、FBG、Hb Alc、TG、TC、LDL-C分别为(5.80±3.87)年、(148.76±13.20)mm Hg(1 mm Hg=0.133 k Pa)、(9.41±4.20)mmol/L、(11.31±2.15)%、(7.34±1.81)、(6.84±0.86)、(4.84±1.81)mmol/L,对照组分别为(3.65±2.11)年、(124.62±9.67)mm Hg、(8.17±4.37)mmol/L、(7.06±1.85)%、(4.29±1.76)、(5.04±0.45)、(3.21±2.01)mmol/L,两组比较差异均有统计学意义(均P0.05)。美国国立卫生研究院脑卒中量表(the national institutes of health stroke scale,NIHSS)评分≤3分的患者Hb A1c为(7.27±1.42)%,NIHSS评分3分的患者为(9.67±1.68)%,比较差异有统计学意义(P0.05)。结论在糖尿病合并急性脑卒中的患者中,以缺血性小卒中多见,约占69.7%;糖尿病患者中病程长及高收缩压、高血脂、高Hb A1c更易并发脑梗塞;Hb Alc越高,糖尿病合并脑梗死的神经功能缺损程度越重。     

8 264例住院孕妇妊娠期糖尿病的发病率及其危险因素分析

目的 分析8 264例住院孕妇妊娠期糖尿病（GDM）的发病情况及危险因素,为其防治提供依据。方法 收集2013年1月 - 2018年12月在海南妇产科医院住院分娩的孕妇8 264例,参考2010年国际妊娠糖尿病研究协会（IADPSG）制定的GDM诊断标准分为GDM组（n = 1 207）和非GDM组（n = 7 057）。采用自行设计的调查表收集相关临床资料,应用单因素及多因素logistic回归分析GDM发生的危险因素。结果 8 264例孕妇发生GDM 1 207例,GDM发病率为14.61％。多因素logistic回归分析显示,年龄≥35岁（OR = 2.337,95%CI:1.512～5.480）、孕前BMI≥25 kg/m2（OR = 3.193,95%CI:2.485～10.108）、孕次≥3次（OR = 2.104,95%CI:1.382～4.927）、产次≥3次（OR = 1.862,95%CI:1.204～3.218）、流产次数≥2次（OR = 2.902,95%CI:2.114～7.913）、高能量摄食（OR = 5.714,95%CI:4.526～12.685）及饮食不规律（OR = 3.319,95%CI:2.905～10.794）是GDM发生的危险因素。结论 年龄≥35岁、孕前BMI≥30岁、孕次≥3次、产次≥3次、流产次数≥2次、高能量摄食及饮食不规律是GDM发生的危险因素,临床上应对此类孕妇加强GDM的早期筛查。     

老年糖尿病患者社会支持现状及影响因素分析

目的了解宁夏回族自治区银川市社区老年糖尿病患者社会支持情况及其相关因素。方法采用问卷调查对银川市4个社区共208例老年糖尿病患者进行调查,内容包括个人一般情况及社会支持状况。结果银川市社区老年糖尿病患者客观支持评分(7.78±2.49)分,主观支持评分(20.74±336)分,社会支持利用度(7.12±2.70)分和社会支持总分(35.63±6.27)分,均低于国内常模,差异有统计学意义(P<0.05);在婚的老年糖尿病患者的客观支持(8.24±2.17)分、主观支持(21.26±3.45)分及社会支持总分(36.76±5.68)分均高于丧偶者(6.02±2.88)、(18.63±3.59)、(31.12±6.35)分,差异有统计学意义(P<0.05);不同受教育程度的老年糖尿病患者的社会支持利用度差异有统计学意义(F=2.616,P=0.036);不同居住情况的老年糖尿病患者客观支持(F=12.278,P=0.000)、主观支持(F=3.229,P=0.013)及社会支持总分(F=7.686,P=0.000)差异有统计学意义;退休前工作单位不同,其主观支持差异有统计学意义(F=2.773,P=0.043);...     

江苏淮安市老年2型糖尿病人群血脂异常的患病情况及其影响因素

目的了解淮安市老年2型糖尿病(以下简称糖尿病)人群血脂异常患病情况及其影响因素,为社区老年糖尿病人群血脂异常的防治提供依据。方法采用随机整群抽样方法,纳入5 914名社区老年糖尿病患者,采用统一问卷询问其基本情况、饮食结构、生活方式和疾病史等,测量其身高、体重、腰围和血压,并检测其血糖和血脂,采用多因素logistic回归分析老年糖尿病人群血脂异常的影响因素。结果淮安市老年糖尿病人群血脂异常患病率为52.18%。多因素非条件Logistic回归分析显示,年龄增加、城市居住、血脂异常家族史、超重肥胖、中心性肥胖、高血压和血糖未控制是患血脂异常的危险因素,而大专及以上是患血脂异常的保护因素。结论淮安市老年糖尿病人群血脂异常患病率偏高,避免超重肥胖(中心性肥胖)、控制血压和血糖水平均有助于降低血脂异常的患病率,进而降低心血管并发症的发病风险。     

Ⅱ型糖尿病患者医院感染危险因素研究

目的 探讨Ⅱ型糖尿病患者医院感染发病情况、危险因素及预防措施。方法 采用回顾性调查的方法,分析Ⅱ型糖尿病患者医院感染发生率及其相关危险因素。结果 418例Ⅱ型糖尿病患者中,发生医院感染66例,感染率为15.79％,高于同期医院平均医院感染发病率4.18％(P<0.01);病原菌中,G~-杆菌占61.91％;医院感染主要与住院时间长,原发病控制情况(尿酮体),有并发症及治疗措施(应用抗菌药物和激素、侵入性医疗操作)等有关。结论 Ⅱ型糖尿病患者医院感染发病率高于平均医院感染发病率,G~-杆菌是主要病原菌。积极控制血糖,防治并发症,合理应用抗菌药物,尽量避免侵入性医疗操作和注意提高患者免疫力等,是防治Ⅱ型糖尿病患者发生医院感染的有效措施。     

Epidemiologic studies of psychosocial factors associated with quality of life among patients with chronic diseases in Japan

A link between affective disturbances and physical disorders has been suggested since the Greco-Roman era. However, evidence supporting an association between mind and body is limited and mostly comes from North America and Europe. Additional local epidemiologic studies are needed so that more evidence can be collected on effective treatments and health management. Epidemiologic studies of Japanese with rheumatoid arthritis (RA) and those on chronic hemodialysis examined the association between psychosocial factors and patient quality of life (QOL). Strong associations among depression, social support, and patient QOL were confirmed, which supports the findings of studies performed in Western countries. In addition, disparities between the perspectives of patients with RA and their doctors were observed. Alexithymia, a personality construct that reflects a deficit in the cognitive processing of emotion, had a stronger independent association with increased risk of 5-year mortality than did depression among patients with chronic hemodialysis. Physiological, biological, and psychosocial factors are associated and independently and interactively determine our health. Epidemiology is a powerful tool for identifying effective points of intervention, after considering all possible confounders. Future studies must clarify how health can be improved by using a psychosocial approach.     

北京市居民2型糖尿病现况调查和危险因素研究

目的 揭示北京市居民2型糖尿病的流行趋势及探索相关危险因素.方法 采用多因素logistic回归模型分析北京市居民2型糖尿病的相关危险因素.结果 共调查22301人,其中男性9836人,女性12465人,60岁以上2658人,占11.92%.男性(OR=1.453)、有糖尿病遗传史(OR=2.751)、中老年人(OR=1.584)、高血压(OR=1.338)、腹型肥胖(OR=1.741)、超重或肥胖(OR=1.098)、水果摄入量少(OR=1.430)、血清高甘油三酯(OR=1.767)和高胆固醇水平(OR=1.315)是影响2型糖尿病发生的危险因素.结论 控制血压在正常范围、控制体重、增加水果摄入量和降低血清甘油三酯及胆固醇水平,对于北京市居民预防和控制2型糖尿病发生具有重要意义.

Abstract：

Objective To disclose the epidemiological status of type 2 diabetes mellitus and its related risk factors in adults in Beijing.Methods Logistic model was applied to analyze the relationship between the risk factors and type 2 diabetes mellitus.Results A total of 22301 people were studied,of whom 9836 were males,12465 females,and 2658 of them aged over 60(accounting for 11.92%).The risk factors,which might cause diabetes,would include being male(OR=1.453),with genetic history(OR=2.751),people older than 40(OR=1.584),with hypertension(OR=1.338),with larger waist circumference(OR=1.741),overweight or obesity(OR=1.098),low consumption of fruits(OR=1.430),hypertriglyceridemia(OR=1.767)and hypercholesterolemia (OR=1.315).Conclusion It is of great importance to carry out prevention and controI of type 2 diabetes mellitus programs to eliminate the risk factors among adults in Beijing,with contents as:keeping the blood pressure and weight within the normal range,increasing fruit intake,decreasing the triglyceride and cholesterol levels.     

2型糖尿病并发症患者的生命质量及其影响因素

目的：探讨2型糖尿病并发症患的生命质量及其影响因素。方法：采用特异性糖尿病生命质量量表，调查102例2型糖尿病并发症患的生命质量。采用非条件Logistic回归模型对资料进行分析。结果：2型糖尿病并发症患生命质量普遍降低，年长患的生命质量优于年轻患。主食、荤油摄入过多，喜食咸味是2型糖尿病并发症患低生命质量的危险因素，OR值分别为2．515、2．167、1．920。强化治疗、适当增加业余体力 活动量是其保护因素，OR值分别为0．976和0．485。结论：鼓励2型糖尿病并发症患加强糖尿病治疗、适当增加业务体力活动，限制主食、荤油、盐的摄入，将有助于改善生命质量。