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尽管在加拿大安大略省为1型糖尿病提供了普遍的计划,但胰岛素吸收的持续差异仍然存在
Youstina Soliman1, Karl Everett2, Rayzel Shulman2,3,4
1Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Diabetes, obesity & metabolism
|July 26, 2024
概括
社会劣势与1型糖尿病 (T1D) 的成年人使用胰岛素的减少有关,尽管有一个通用计划. 持续存在的差异凸显了需要解决障碍,以平等获得糖尿病技术的障碍.
科学领域:
- 内分泌学 在内分泌学.
- 公共卫生 公共卫生
- 健康 公平 卫生 公平
背景情况:
- 1型糖尿病 (T1D) 的管理依赖于先进的技术,如胰岛素.
- 在加拿大安大略省,有一个普遍的,公共资助的胰岛素计划.
- 社会劣势可能会影响T1D技术的获取和使用.
研究的目的:
- 检查T1D成年人的社会劣势和胰岛素使用之间的关联.
- 为了确定在胰岛素计划入学中的社会差异是否随着时间的推移而改变.
- 为促进平等获得糖尿病管理工具的战略提供信息.
主要方法:
- 基于人口的横截面研究,使用来自加拿大安大略省的行政医疗保健数据.
- 后勤回归来评估邻里社会劣势 (安大略省边缘化指数五分位数) 与T1D成年人胰岛素使用之间的联系.
- 顺序后勤回归用于评估从2006年到2022年向胰岛素计划申请者的社会劣势趋势.
主要成果:
- 在27453名患有T1D的成年人中,60%使用了胰岛素;较大的社会劣势与较低的使用相关 (aOR 0.44).
- 使用中的社会差异最初减少,但从2020-2022年开始增加.
- 2007年至2022年期间,计划申请人的社会贫困五分位数更高的几率没有显著变化.
结论:
- 尽管普遍获得,但基于社会劣势的T1D患者在胰岛素使用方面存在显著差异.
- 金融和非金融障碍继续阻碍胰岛素技术的公平采用.
- 需要采取进一步的干预措施,以确保所有患有T1D的人都可以从胰岛素治疗中受益.
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