根据服务组合和其他相关因素研究随访类型的影响,在新诊断为2型糖尿病且初始控制不佳的人群中,HbA1c水平降低。
常规临床实践条件下队列的分析观察研究。
马德里有262个初级卫生保健中心。
1838名年龄超过18岁的人,新诊断为2型糖尿病,初始HbA1c水平≥7%,如果年龄超过75岁,则≥8.5%。
风险敞口变量是根据投资组合的跟进类型,归类为最小值,中等,和最佳,根据实施的干预措施数量和治疗药物计划类型的周期性。
对共病进行了研究,治疗药理学计划,饮食-运动建议和剥夺指数。主要结果是最终和初始HbA1c之间的差异。
随访2年后,HbA1c平均下降-1.7个百分点(95%CI:-1.6;-1.8),在最佳随访的患者中,高0.36分:-2.1(95%CI:-1.7;-2.4)。与HbA1c下降相关的因素是最佳随访-0.29(95%CI:-0.5;-0.1),中等随访-0.26(95%CI:-0.5;-0.0),和初始HbA1c值-0.9(95%CI:-0.9;-0.9。与增加相关的因素是胰岛素治疗和生活在社会弱势群体中。
在新诊断为糖尿病的患者中,血糖控制得到了改善,其中按照服务组合中的建议进行了最佳随访。
To study the effect of the type of follow-up according to Service Portfolio and other associated factors, in the reduction of HbA1c levels in people with a new diagnosis of type 2 diabetes and poor initial control.
Analytical observational study of a cohort under routine clinical practice conditions.
262 Primary Health Care Centres in Madrid.
1,838 individuals older than 18 years with a new diagnosis of type 2 DM and initial HbA1c levels ≥ 7%, or ≥ 8.5% if older than 75 years.
The exposure variable was the type of follow-up according to Portfolio, categorised as minimum, medium, and optimal, according to the number of interventions performed and periodicity of type of therapeutic-pharmacological plan.
A study was made of the comorbidity, therapeutic-pharmacological plan, diet - exercise advice and deprivation index. The main outcome was the difference between the final and initial HbA1c.
After 2 years of follow-up there was a mean decrease in HbA1c by -1.7 percentage points (95% CI: -1.6;-1.8), which was 0.36 points higher in patients with optimal follow-up: -2.1 (95% CI: -1.7;-2.4). The factors associated with a decrease in HbA1c were the optimal follow-up -0.29 (95% CI: -0.5;-0.1), the medium follow-up -0.26 (95% CI: -0.5; -0.0), and the initial HbA1c value -0.9 (95% CI: -0.9; -0.9. The factors associated with the increase were insulin treatment and living in socially disadvantaged areas.
Glycaemic control was improved in patients with a new diagnosis of diabetes in which optimal follow-up is performed as proposed in the Service Portfolio.