Use and Impact of Type 2 Diabetes Prevention Interventions.
Use and Impact of Type 2 Diabetes Prevention Interventions.
复制标题
DOI：
10.1016/j.amepre.2022.04.002
复制
发表时间：
2022-10
影响因子：
5.5
通讯作者：
Bullard, Kai McKeever
中科院分区：
文献类型：
--
作者：
Campione, Joanne R.;Ritchie, Natalie D.;Fishbein, Howard A.;Mardon, Russell E.;Johnson, Maurice C., Jr.;Pace, Wilson;Birch, Rebecca Jeffries;Seeholzer, Eileen L.;Zhang, Xuanping;Proia, Krista;Siegel, Karen R.;Bullard, Kai McKeever
随机对照试验发现，2型糖尿病可以通过二甲双胍药物和循证生活方式改变项目在高危人群中预防。本研究的目的是评估在现实世界的临床实践环境中预防2型糖尿病的干预措施的使用，并确定对糖尿病相关临床结果的影响。2020年进行的分析使用了2010-2018年两个卫生系统中69,434名年龄≥18岁的2型糖尿病高风险患者的电子健康记录数据。检查了处方二甲双胍、生活方式改变计划、减肥手术和三者联合使用的使用和影响。进行了一项亚分析，以检查国家糖尿病预防计划患者的摄取和保留。服用二甲双胍或接受减肥手术的患者的平均HbA1c值在干预前和干预后下降（- 0.067%,p<0.001）。在参与国家糖尿病预防计划生活方式改变计划的患者中，干预后2型糖尿病发病率比例为：未参加者为14.0%，部分参加者为12.8%，参加≥4次的为7.5% （p<0.001）。在转入国家糖尿病预防计划生活方式改变计划的患者中，摄取率很低（1-3次疗程为13%，≥4次疗程为15%），尤其是男性和西班牙裔患者。研究结果表明，二甲双胍和减肥手术可以改善HbA1c水平，参与国家糖尿病预防计划可以降低2型糖尿病的发病率。努力增加这些干预措施的使用可能对糖尿病相关的健康结果产生积极影响。
RCTs have found that type 2 diabetes can be prevented among high-risk individuals by metformin medication and evidence-based lifestyle change programs. The purpose of this study is to estimate the use of interventions to prevent type 2 diabetes in real-world clinical practice settings and determine the impact on diabetes-related clinical outcomes. The analysis performed in 2020 used 2010–2018 electronic health record data from 69,434 patients aged ≥18 years at high risk for type 2 diabetes in 2 health systems. The use and impact of prescribed metformin, lifestyle change program, bariatric surgery, and combinations of the 3 were examined. A subanalysis was performed to examine uptake and retention among patients referred to the National Diabetes Prevention Program. Mean HbA1c values declined from before to after intervention for patients who were prescribed metformin (−0.067%; p<0.001) or had bariatric surgery (−0.318%; p<0.001). Among patients referred to the National Diabetes Prevention Program lifestyle change program, the type 2 diabetes postintervention incidence proportion was 14.0% for nonattendees, 12.8% for some attendance, and 7.5% for those who attended ≥4 sessions (p<0.001). Among referred patients to the National Diabetes Prevention Program lifestyle change program, uptake was low (13% for 1–3 sessions, 15% for ≥4 sessions), especially among males and Hispanic patients. Findings suggest that metformin and bariatric surgery may improve HbA1c levels and that participation in the National Diabetes Prevention Program may reduce type 2 diabetes incidence. Efforts to increase the use of these interventions may have positive impacts on diabetes-related health outcomes.
登录
查看更多内容
影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
13.8
作者：
Ali, Mohammed K.;Bullard, Kai McKeever;Gregg, Edward W.
通讯作者：
Gregg, Edward W.
影响因子：
7.2
作者：
Nhim, Kunthea;Gruss, Stephanie M.;Albright, Ann
通讯作者：
Albright, Ann
影响因子：
11.5
作者：
Hostalek U;Gwilt M;Hildemann S
通讯作者：
Hildemann S