The role of active family nutritional support in Navajos' type 2 diabetes metabolic control
The role of active family nutritional support in Navajos' type 2 diabetes metabolic control
复制标题
DOI：
10.2337/diacare.26.10.2829
复制
发表时间：
2003-10-01
期刊：
影响因子：
16.2
通讯作者：
Bauer, M
中科院分区：
文献类型：
--
作者：
Epple, C;Wright, AL;Bauer, M
目的：我们研究了积极的家庭营养支持是否与改善2型糖尿病患者的代谢结果有关。研究设计和方法--通过对163名糖尿病患者的便利样本的调查，利用早期人种学研究中确定的变量，评估了家庭支持的存在。糖尿病结局指标(HbA(1c)、血糖、甘油三酯、总胆固醇、肌酐以及收缩和舒张压指标)从参与者的医疗记录中提取。结果：在双变量分析中，家庭支持的所有指标都与代谢控制的一个或多个指标有关。在多变量分析中，如果另一个人做饭，受访者更有可能处于甘油三酯(P<；0.05)、胆固醇(P<；0.05)和糖化血红蛋白(1c)(P<；0.05)的最佳三分位数。在购买/烹调“清淡”食物的家庭中，受访者更有可能处于甘油三酯(P<；0.005)和胆固醇水平(P<；0.005)的最佳三分位数，而那些家庭成员一起吃“清淡”食物的受访者更有可能处于甘油三酯最佳三分位数(P<；0.005)。当所有三个支持变量都进入多变量模型时，只有“其他家庭成员做饭”这一变量与甘油三酯(P=0.05)、糖化血红蛋白(1c)(P<；0.05)或胆固醇水平(P<；0.05)显著相关。这些关系在患有糖尿病的妇女中最为明显。结论：积极的家庭营养支持，按文化相关类别衡量，与甘油三酯、胆固醇和糖化血红蛋白水平的控制显著相关。研究结果表明，在设计糖尿病护理策略时，家庭是饮食个体比单独个体更有用的干预单位。
OBJECTIVE - We examined if active family nutritional support is associated with improved metabolic outcomes for Dine (Navajo) individuals living with type 2 diabetes.RESEARCH DESIGN AND METHODS - The presence of family support, using variables identified in earlier ethnographic research, was assessed via surveys in a convenience sample of 163 diabetic individuals. Diabetes outcome measures (HbA(1c), serum glucose, triglycerides, total cholesterol, creatinine, and systolic and diastolic blood pressure measures) were extracted from participants' medical records. Bivariate analyses and multiple logistic regressions were conducted.RESULTS - All measures of family support showed a relation with one or more indicators of metabolic control in bivariate analyses. In multivariate analyses, respondents were more likely to be in the best tertile for triglyceride (P < 0.05), cholesterol (P < 0.05), and HbA(1c) (P < 0.05) if another person cooked most of the meals. Respondents in families who bought/cooked "light" foods were more likely to be in the best tertile for triglyceride (P < 0.005) and cholesterol levels (P < 0.005), and those in families whose members ate "light" foods with them were more likely to be in the best tertile for triglycerides (P < 0.005). When all three support variables were entered into a multivariate model, only the variable "other family members cook the majority of the meals" was significantly associated with being in the lowest triglyceride (P = 0.05), HbA(1c) (P < 0.05), or cholesterol tertiles (P < 0.05). These relationships were most evident for women with diabetes.CONCLUSIONS - Active family nutritional support, as measured by culturally relevant categories, is significantly associated with control of triglyceride, cholesterol, and HbA,, levels. The findings suggest that the family is a more useful unit of intervention for Dine individuals than for the individual alone when designing diabetes care strategies.