未经证实:关于无家可归患者的糖尿病控制数据缺乏。
未经评估:我们回顾性地收集了与2型糖尿病相关的测量,社会人口统计学,和临床指标来自2019年在纽约市收容所看到的所有成年糖尿病患者的医疗记录(n=418;无家可归:356,居住:58)。结果是糖尿病管理不当的发生率和相关因素。
UNASSIGNED:双变量分析表明,无家可归的患者(63%的黑人;32%的西班牙裔)134/304(43·9%)比定居的患者13/57(22·8%)更有可能患有糖尿病(OR2·67,CI1·38-5·16,p=0·003)。无家可归者的平均HbA1c(8.4%,SD±2·6)高于户籍人员(7·3%,SD±1·8,p=0·002)。在逻辑回归中,居住状态(OR0·42,CI0·21-0·84,p=0·013),年龄较大(OR0·97,CI0·95-0·99,p=0·004),非西班牙裔/拉丁裔与糖尿病管理良好相关.在无家可归的人中,非西班牙裔/拉丁裔(OR0·61,CI0·37-0·99,p=0·047)和年龄较大(0·96,CI0·94-0·99,p=0·003)与糖尿病管理良好相关。在线性回归中,精神疾病(-0·11,p=0·048)和年龄较大(-0·15,p=0·010)与较低的HbA1c相关,建议在各自的庇护所提供更好的支持。糖尿病管理不当与包括物质或酒精使用障碍在内的几种传统风险因素之间没有统计学上的显着关联。健康保险,或其他慢性疾病。
UNASSIGNED:庇护所或庇护所诊所的干预措施除了解决传统的危险因素外,还应针对亚组,以改善糖尿病控制。可以考虑采用mHealth策略来提高参与度,护理交付,和服药。最终,无家可归本身需要解决。
UNASSIGNED:没有可申报的资金来源。
UNASSIGNED: There is a dearth of data regarding diabetes control among patients experiencing homelessness.
UNASSIGNED: We retrospectively collected type 2 diabetes-related measurements, sociodemographic, and clinical indicators from medical records of all incoming adults with diabetes (n = 418; homeless: 356 and domiciled: 58) seen in shelter-clinics in New York City in 2019. The outcomes were the rates of inadequately managed diabetes and associated factors.
UNASSIGNED: Bivariate analysis showed that patients experiencing homelessness (63% Black; 32% Hispanic) 134/304 (43⋅9%) were more likely than domiciled patients 13/57 (22·8%) to have inadequately managed diabetes (OR 2⋅67, CI 1·38-5·16, p = 0⋅003). The average HbA1c among homeless (8·4%, SD± 2·6) was higher than that of domiciled persons (7·3%, SD± 1·8, p = 0·002). In logistic regression, domiciled status (OR 0⋅ 42, CI 0·21 - 0·84, p = 0·013), older age (OR 0·97, CI 0·95 - 0·99, p = 0·004), and non-Hispanic/Latino ethnicity were associated with well-managed diabetes. Among persons experiencing homelessness, non-Hispanic/Latino (OR 0·61, CI 0·37-0·99, p = 0·047) and older age (0·96, CI 0·94-0·99, p = 0·003) were associated with well-managed diabetes. In linear regression, mental illness (-0·11, p = 0·048) and older age (-0·15, p = 0·010) were associated with lower HbA1c, suggesting better support in respective shelters. There was no statistically significant association between inadequately managed diabetes with several traditional risk factors including substance or alcohol use disorder, health insurance, or other chronic diseases.
UNASSIGNED: Interventions at shelters or shelter-clinics should target subgroups in addition to addressing traditional risk factors to improve diabetes control. mHealth strategies could be considered to improve engagement, care delivery, and medication taking. Ultimately, homelessness itself needs to be addressed.
UNASSIGNED: There are no funding sources to declare.