Factors that influence improvement for patients with poorly controlled type 2 diabetes
Factors that influence improvement for patients with poorly controlled type 2 diabetes
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DOI：
10.1016/j.diabres.2006.03.023
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发表时间：
2006-12-01
影响因子：
5.1
通讯作者：
Daly, Jeanette
中科院分区：
文献类型：
--
作者：
Hartz, Arthur;Kent, Sarah;Daly, Jeanette
目的：评估原因改善控制最初控制不佳的患者diabetes.Research设计和方法：患者在7个做法与2型糖尿病被选中，如果在6个月内，他们有两个糖化血红蛋白（HbA1c）水平至少为8.0%。患者因素，可能会影响控制进行了比较，根据他们的最后两个HbA1c levels.Results分组的患者：审查643例糖尿病患者的医疗记录治疗的29名临床医生确定了69名研究患者。经过至少1年的随访，26例患者控制良好，14例控制中等，29例控制不佳。在基线之前，变得受控与性别、年龄、糖尿病持续时间、BMI或HbAlc水平没有显著相关。它与更多的药物使用呈负相关（P = 0.04），与糖尿病的理解（P = 0.03），遵守膳食计划的建议（P = 0.001）和血糖监测（P = 0.02）呈正相关。31%的控制了病情的患者的生活环境发生了变化。不推进药物治疗的原因可能是合理的69%的患者谁仍然controlled.Conclusion：改善控制在很大程度上取决于病人的自我护理行为。(c)2006爱思唯尔爱尔兰有限公司保留所有权利。
Objective: Assess reasons for improved control for patients with initially poorly controlled diabetes.Research design and methods: Patients in seven practices with type 2 diabetes were selected if within a 6-month period they had two glycosylated hemoglobin (HbA1c) levels of at least 8.0%. Patient factors that may influence control were compared for patients grouped according to their last two HbA1c levels.Results: Review of 643 medical records of diabetic patients treated by 29 clinicians identified 69 study patients. After at least 1 year of follow-up 26 patients became well controlled, 14 had intermediate control, and 29 remained in poor control. Becoming controlled was not significantly associated with gender, age, duration of diabetes, BMI, or HbAlc levels prior to baseline. It was inversely associated with greater use of medications (P = 0.04), and positively associated with understanding of diabetes (P = 0.03), adherence to recommendations for meal plan (P = 0.001), and glucose monitoring (P = 0.02). Thirty-one percent of patients who became controlled had a change in life circumstances. Reasons for not advancing medications were probably justified for 69% of patients who remained uncontrolled.Conclusion: Improved control depends largely on patient self-care behaviors. (c) 2006 Elsevier Ireland Ltd. All rights reserved.