在社区医疗中心患者中糖尿病并发症与多种疾病模式的变化
Ana R Quiñones1,2, Jun Hwang3, Nathalie Huguet3
1Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA. quinones@ohsu.edu.
Journal of general internal medicine
|March 4, 2025
概括
与其他慢性疾病一起管理糖尿病 (DM) 会增加并发症风险. 患有DM加上精神和体质疾病的患者在社区卫生中心面临DM并发症的最高风险.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 慢性疾病管理 慢性疾病管理
- 流行病学 流行病学
背景情况:
- 多种疾病,定义为糖尿病 (DM) 与至少一种其他慢性疾病,使得实现适当的DM控制变得复杂.
- 社区医疗中心 (CHC) 越来越多地管理具有复杂健康状况的患者.
研究的目的:
- 为了评估DM相关并发症的风险跨不同的多病态模式在CHC患者.
- 为了确定特定的多病症概况,与增加的并发症风险相关.
主要方法:
- 一项回顾性队列研究利用了来自ADVANCE临床数据网络的数据,其中包括132,765名45岁及以上的DM患者.
- 患者被分为相互排斥的多病症组:仅DM,DM+心脏代谢,DM+其他体征,DM+精神,DM+精神+体征.
- 该研究评估了疾病的积累和在随访期间经历急性,微血管,宏血管或其他DM并发症的风险.
主要成果:
- 在基线时,55.0%的患者患有心脏代谢多病症的DM,22.5%患有精神和体质多病症的DM.
- 在仅患有DM的患者中,很大一部分 (76.5%) 在研究结束时发展出多病症.
- 与仅患有DM的患者相比,DM+精神+体质多病症组的经过调整后患有任何DM并发症的风险高出13.4%.
结论:
- 医疗保健中心为越来越多的患有复杂并发症的患者提供服务.
- 定制疾病管理策略以解决同时出现的心血管和心理健康问题,对于预防DM并发症至关重要.
- 个性化护理计划对于减轻糖尿病和多种慢性疾病患者的风险至关重要.
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