Intermediate hyperglycaemia, diabetes and blood pressure in rural Bangladesh: five-year post-randomisation follow-up of the DMagic cluster-randomised controlled trial.

Intermediate hyperglycaemia, diabetes and blood pressure in rural Bangladesh: five-year post-randomisation follow-up of the DMagic cluster-randomised controlled trial.
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孟加拉国农村的中等高血糖,糖尿病和血压:DMAGIC聚类随机对照试验的五年随机后随访。

DOI:
10.1016/j.lansea.2022.100122
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发表时间:
2023-03
期刊:
LANCET REGIONAL HEALTH - SOUTHEAST ASIA
影响因子:
--
通讯作者:
Azad, Kishwar
Azad, Kishwar
中科院分区:
其他
文献类型:
--
作者:
Fottrell, Edward;King, Carina;Ahmed, Naveed;Shaha, Sanjit Kumer;Morrison, Joanna;Pires, Malini;Kuddus, Abdul;Nahar, Tasmin;Haghparast-Bidgoli, Hassan;Khan, A. K. Azad;Azad, Kishwar

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DMagic试验表明,通过促进社区团体提供的参与性学习和行动(PLA)社区动员,以及移动健康语音消息干预措施改善了孟加拉国的糖尿病知识,PLA干预措施减少了糖尿病的发生。我们评估干预活动停止后三年的干预效果。随机化后5年,我们对居住在96个DMagic村庄的年龄≥30岁的成年人随机样本以及2016年DMagic试验开始时确定为中度高血糖症的人群进行了横断面调查。主要结局为:1)中度高脂血症和糖尿病的合并患病率; 2)2016年中度高脂血症人群中糖尿病的五年累积发病率。次要结果是:体重、BMI、腰围和臀围、血压、知识和行为。主要分析比较了干预组与对照组在聚类水平上的结果。从随机选择的1623名(82%)成人和1817名(87%)中度高脂血症队列中收集数据。2018年移动健康集群中糖尿病知识的改善在2021年不再明显。相对于对照组,PLA组的知识水平仍然显著较高,但在中度高血糖和糖尿病患病率(OR(95%CI)1.23(0.89,1.70))或5年糖尿病发病率(1.04(0.78,1.40))的主要结局方面没有观察到差异。相对于对照,PLA簇中的高血压(0.73(0.54,0.97))和高血压对照(2.77(1.34,5.75))得到改善。PLA对中度高血压和糖尿病的干预效果在干预结束后3年未持续,但观察到血压降低方面的益处。 英国:MR/M016501/1(DMagic试验); MR/T023562/1(DClare研究),分别在全球慢性病联盟(GACD)糖尿病和扩大规模项目下进行。
The DMagic trial showed that participatory learning and action (PLA) community mobilisation delivered through facilitated community groups, and mHealth voice messaging interventions improved diabetes knowledge in Bangladesh and the PLA intervention reduced diabetes occurrence. We assess intervention effects three years after intervention activities stopped. Five years post-randomisation, we conducted a cross-sectional survey among a random sample of adults aged ≥30-years living in the 96 DMagic villages, and a cohort of individuals identified with intermediate hyperglycaemia at the start of the DMagic trial in 2016. Primary outcomes were: 1) the combined prevalence of intermediate hyperglycaemia and diabetes; 2) five-year cumulative incidence of diabetes among the 2016 cohort of individuals with intermediate hyperglycaemia. Secondary outcomes were: weight, BMI, waist and hip circumferences, blood pressure, knowledge and behaviours. Primary analysis compared outcomes at the cluster level between intervention arms relative to control. Data were gathered from 1623 (82%) of the randomly selected adults and 1817 (87%) of the intermediate hyperglycaemia cohort. 2018 improvements in diabetes knowledge in mHealth clusters were no longer observable in 2021. Knowledge remains significantly higher in PLA clusters relative to control but no difference in primary outcomes of intermediate hyperglycaemia and diabetes prevalence (OR (95%CI) 1.23 (0.89, 1.70)) or five-year incidence of diabetes were observed (1.04 (0.78, 1.40)). Hypertension (0.73 (0.54, 0.97)) and hypertension control (2.77 (1.34, 5.75)) were improved in PLA clusters relative to control. PLA intervention effect on intermediate hyperglycaemia and diabetes was not sustained at 3 years after intervention end, but benefits in terms of blood pressure reduction were observed. UK: MR/M016501/1 (DMagic trial); MR/T023562/1 (DClare study), under the Global Alliance for Chronic Diseases (GACD) Diabetes and Scale-up Programmes, respectively.
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