Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.
Adherence to diabetes guidelines for screening, physical activity and medication and onset of complications and death.
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DOI：
10.1016/j.jdiacomp.2015.07.005
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发表时间：
2015-11
影响因子：
3
通讯作者：
Yashkin AP
中科院分区：
文献类型：
--
作者：
Chen Y;Sloan FA;Yashkin AP
分析遵守糖尿病护理指南与定期筛查之间的关系；体力活动；和药物治疗——以及糖尿病并发症和死亡率。结果包括充血性心力衰竭（CHF）、中风、肾衰竭、中度下肢并发症、下肢截肢、增殖性糖尿病视网膜病变（PDR）以及随访期间的死亡率。 2003 年健康与退休研究 (HRS) 糖尿病研究的参与者是 65 岁以上的人，并在随访期间（2004 年 8 月）提出了医疗保险索赔。遵守筛查建议可降低患 CHF（比值比 (OR)=0.83；95% 置信区间 (CI)：0.72-0.96）、中风（OR=0.80；95% CI：0.68-0.94）的风险；肾功能衰竭（OR=0. 82；95% CI：0.71-0.95）；和死亡（OR=0.86；95% CI：0.74-0.99）。坚持体育活动建议可降低中风（OR=0.64；95% CI：0.45-0.90）、肾衰竭（OR=0.71；95% CI：0.52-0.97）、中度下肢并发症（OR=0.71；95% CI：0.51-0.99）、下肢截肢（OR：0.31， 95% CI：0.11-0.85）和死亡（OR=0.56，95% CI：0.41-0.77）。药物依从性与较低的 PDR 风险相关（OR=0.35，95% CI：0.13-0.93）。遵守筛查、身体活动和药物指南与降低糖尿病并发症和死亡风险相关。不同结果指标的依从性的相对重要性不同。
Analyzed relationships between adherence to guidelines for diabetes care--regular screening; physical activity; and medication—and diabetes complications and mortality. Outcomes were onset of congestive heart failure (CHF), stroke, renal failure, moderate complications of lower extremities, lower-limb amputation, proliferative diabetic retinopathy (PDR), and mortality during follow-up. Participants were persons aged 65+ in the Health and Retirement Study (HRS) 2003 Diabetes Study and had Medicare claims in follow-up period (2004-8). Adherence to screening recommendations decreased risks of developing CHF (odds ratio (OR)=0.83; 95% confidence interval (CI): 0.72-0.96), stroke (OR=0.80; 95% CI: 0.68-0.94); renal failure (OR=0. 82; 95% CI: 0.71-0.95); and death (OR=0.86; 95% CI: 0.74-0.99). Adherence to physical activity recommendation reduced risks of stroke (OR=0.64; 95% CI: 0.45-0.90), renal failure (OR=0.71; 95% CI: 0.52-0.97), moderate lower-extremity complications (OR=0.71; 95% CI: 0.51-0.99), having a lower limb amputation (OR: 0.31, 95% CI: 0.11-0.85), and death (OR=0.56, 95% CI: 0.41-0.77). Medication adherence was associated with lower risks of PDR (OR=0.35, 95% CI: 0.13-0.93). Adherence to screening, physical activity and medication guidelines were associated with lower risks of diabetes complications and death. Relative importance of adherence differed among outcome measures.