PDF(Pubmed)
Abstract：
UNASSIGNED: Based on the long-lasting diabetes management challenges in the United States, the objective was to examine glycemic levels among a nationally representative sample of people with diabetes stratified by prescribed antihyperglycemic treatment regimens and contextual factors.
UNASSIGNED: This serial cross-sectional study used United States population-based data from the 2015 to March 2020 National Health and Nutrition Examination Surveys (NHANES). The study included non-pregnant adults (≥20 years old) with non-missing A1C and self-reported diabetes diagnosis from NHANES. Using A1C lab values, we dichotomized the outcome of glycemic levels into <7% versus ≥7% (meeting vs. not meeting guideline-based glycemic levels, respectively). We stratified the outcome by antihyperglycemic medication use and contextual factors (e.g., race/ethnicity, gender, chronic conditions, diet, healthcare utilization, insurance, etc.) and performed multivariable logistic regression analyses.
UNASSIGNED: The 2042 adults with diabetes had a mean age of 60.63 (SE = 0.50), 55.26% (95% CI = 51.39-59.09) were male, and 51.82% (95% CI = 47.11-56.51) met guideline-based glycemic levels. Contextual factors associated with meeting guideline-based glycemic levels included reporting an \"excellent\" versus \"poor\" diet (aOR = 4.21, 95% CI = 1.92-9.25) and having no family history of diabetes (aOR = 1.43, 95% CI = 1.03-1.98). Contextual factors associated with lower odds of meeting guideline-based glycemic levels included taking insulin (aOR = 0.16, 95% CI = 0.10-0.26), taking metformin (aOR = 0.66, 95% CI = 0.46-0.96), less frequent healthcare utilization [e.g., none vs. ≥4 times/year (aOR = 0.51, 95% CI = 0.27-0.96)], being uninsured (aOR = 0.51, 95% CI = 0.33-0.79), etc.
UNASSIGNED: Meeting guideline-based glycemic levels was associated with medication use (taking vs. not taking respective antihyperglycemic medication classes) and contextual factors. The timely, population-based estimates can inform national efforts to optimize diabetes management.
UNASSIGNED: This serial cross-sectional study used United States population-based data from the 2015 to March 2020 National Health and Nutrition Examination Surveys (NHANES). The study included non-pregnant adults (≥20 years old) with non-missing A1C and self-reported diabetes diagnosis from NHANES. Using A1C lab values, we dichotomized the outcome of glycemic levels into <7% versus ≥7% (meeting vs. not meeting guideline-based glycemic levels, respectively). We stratified the outcome by antihyperglycemic medication use and contextual factors (e.g., race/ethnicity, gender, chronic conditions, diet, healthcare utilization, insurance, etc.) and performed multivariable logistic regression analyses.
UNASSIGNED: The 2042 adults with diabetes had a mean age of 60.63 (SE = 0.50), 55.26% (95% CI = 51.39-59.09) were male, and 51.82% (95% CI = 47.11-56.51) met guideline-based glycemic levels. Contextual factors associated with meeting guideline-based glycemic levels included reporting an \"excellent\" versus \"poor\" diet (aOR = 4.21, 95% CI = 1.92-9.25) and having no family history of diabetes (aOR = 1.43, 95% CI = 1.03-1.98). Contextual factors associated with lower odds of meeting guideline-based glycemic levels included taking insulin (aOR = 0.16, 95% CI = 0.10-0.26), taking metformin (aOR = 0.66, 95% CI = 0.46-0.96), less frequent healthcare utilization [e.g., none vs. ≥4 times/year (aOR = 0.51, 95% CI = 0.27-0.96)], being uninsured (aOR = 0.51, 95% CI = 0.33-0.79), etc.
UNASSIGNED: Meeting guideline-based glycemic levels was associated with medication use (taking vs. not taking respective antihyperglycemic medication classes) and contextual factors. The timely, population-based estimates can inform national efforts to optimize diabetes management.
摘要：
■基于美国长期的糖尿病管理挑战，本研究的目的是通过处方抗高血糖治疗方案和背景因素对全国代表性的糖尿病患者样本进行血糖水平分层.
■这项连续横断面研究使用了2015年至2020年3月美国国家健康与营养调查（NHANES）的基于人口的数据。该研究包括非妊娠成年人（≥20岁），其A1C未缺失和NHANES自我报告的糖尿病诊断。使用A1C实验室值，我们将血糖水平的结果分为<7%与≥7%(会议与不符合基于指南的血糖水平，分别)。我们通过抗高血糖药物的使用和环境因素对结果进行了分层(例如，种族/民族,性别,慢性疾病,饮食，医疗保健利用，保险,等。)并进行了多变量逻辑回归分析。
■2042名患有糖尿病的成年人的平均年龄为60.63（SE=0.50），55.26%（95%CI=51.39-59.09）为男性，51.82%(95%CI=47.11-56.51)符合基于指南的血糖水平.与符合基于指南的血糖水平相关的背景因素包括报告“优秀”与“不良”饮食（aOR=4.21，95％CI=1.92-9.25）和无糖尿病家族史（aOR=1.43，95％CI=1.03-1.98）。与满足基于指南的血糖水平的较低几率相关的情境因素包括服用胰岛素（aOR=0.16，95％CI=0.10-0.26），服用二甲双胍（aOR=0.66，95%CI=0.46-0.96），较少的医疗保健利用[例如，无vs.≥4次/年(aOR=0.51，95%CI=0.27-0.96)]，没有保险(AOR=0.51，95%CI=0.33-0.79)，等。
■基于会议指南的血糖水平与药物使用相关（服用与不服用各自的抗高血糖药物类别)和环境因素。及时,基于人群的估计可以为国家优化糖尿病管理提供信息.
■这项连续横断面研究使用了2015年至2020年3月美国国家健康与营养调查（NHANES）的基于人口的数据。该研究包括非妊娠成年人（≥20岁），其A1C未缺失和NHANES自我报告的糖尿病诊断。使用A1C实验室值，我们将血糖水平的结果分为<7%与≥7%(会议与不符合基于指南的血糖水平，分别)。我们通过抗高血糖药物的使用和环境因素对结果进行了分层(例如，种族/民族,性别,慢性疾病,饮食，医疗保健利用，保险,等。)并进行了多变量逻辑回归分析。
■2042名患有糖尿病的成年人的平均年龄为60.63（SE=0.50），55.26%（95%CI=51.39-59.09）为男性，51.82%(95%CI=47.11-56.51)符合基于指南的血糖水平.与符合基于指南的血糖水平相关的背景因素包括报告“优秀”与“不良”饮食（aOR=4.21，95％CI=1.92-9.25）和无糖尿病家族史（aOR=1.43，95％CI=1.03-1.98）。与满足基于指南的血糖水平的较低几率相关的情境因素包括服用胰岛素（aOR=0.16，95％CI=0.10-0.26），服用二甲双胍（aOR=0.66，95%CI=0.46-0.96），较少的医疗保健利用[例如，无vs.≥4次/年(aOR=0.51，95%CI=0.27-0.96)]，没有保险(AOR=0.51，95%CI=0.33-0.79)，等。
■基于会议指南的血糖水平与药物使用相关（服用与不服用各自的抗高血糖药物类别)和环境因素。及时,基于人群的估计可以为国家优化糖尿病管理提供信息.
