旨在预防糖尿病病恶化的计划的评估:使用日本市政府的健康检查和索赔数据进行回顾性队列研究
Noriko Ihana-Sugiyama1, Kazuaki Sano2, Takehiro Sugiyama3
1Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, 1-21-1, Toyama, Shinjuku-Ku, Tokyo 162-8655, Japan; Department of Diabetes, Endocrinology, and Metabolism, National Center for Global Health and Medicine Hospital, 1-21-1, Toyama, Shinjuku-Ku, Tokyo 162-8655, Japan.
Diabetes research and clinical practice
|July 31, 2024
概括
日本的糖尿病病恶化预防计划没有显示治疗患者的功能早期改善. 各个市镇的不同结果表明,需要对计划进行改进,以提高预防糖尿病病的有效性.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
- 糖尿病管理 糖尿病管理
背景情况:
- 日本启动了糖尿病病恶化预防计划,以解决一个重大的公共卫生问题.
- 早期评估这一国家计划对2型糖尿病患者功能的影响对于其优化至关重要.
研究的目的:
- 评估日本糖尿病病恶化预防计划对功能的早期影响.
- 评估旨在预防糖尿病病恶化的干预措施的有效性.
主要方法:
- 利用Kokuho数据库从2015年至2021财年的2型糖尿病患者.
- 使用治疗权重的逆概率来分析2016年和2018财年的平均治疗效应.
- 进行了干预和非干预患者之间的比较,以及在实施和不实施的市政当局之间进行比较.
主要成果:
- 干预后3年没有观察到估计的膜过率 (eGFR) 的显著改善 (-0.4毫升/分钟/1.73米2).
- 对89,611/89,685名符合条件的患者的分析显示,不同市区的eGFR变化各不相同.
- 干预和非干预组之间的比较,以及跨市政区的比较,显示对功能没有明显的有益影响.
结论:
- 该计划的初始阶段并没有导致干预患者或市政当局的功能改善.
- 在各市区的eGFR变化中出现的异质结果凸显了对量身定制的干预策略的需求.
- 改进计划是提高预防糖尿病病恶化的必要条件.
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