在尼泊尔坚持糖尿病视网膜病治疗和使用服务的障碍
Raba Thapa1, Sanjita Sharma2, Sunil Thakali2
1Tilganga Institute of Ophthalmology, Kathmandu, Nepal. rabathapa@live.com.
BMC ophthalmology
|September 1, 2025
概括
在尼泊尔,糖尿病视网膜病症 (DR) 治疗的坚持率很低,只有不到一半的患者接受治疗. 缺乏意识和成本是主要障碍,强调需要改善社区接触和获得预防失明的护理.
科学领域:
- 眼科 眼科
- 公共卫生
- 内分泌学
背景情况:
- 在低收入和中等收入国家, 糖尿病是越来越大的健康挑战.
- 糖尿病视网膜病是尼泊尔可预防失明的主要原因.
- 及时干预和持续的跟进对于治疗视力损失和预防视力损失至关重要.
研究的目的:
- 评估患者遵守糖尿病视网膜病 (DR) 护理方案.
- 确定影响患者使用DR护理服务的障碍.
- 探索潜在的促进因素和解决方案,以改善DR护理的坚持.
主要方法:
- 一种混合方法,将回顾性和前性数据收集相结合.
- 140名DR患者的一年随访数据的定量分析.
- 通过聚焦小组讨论和尼泊尔关键信息人采访收集的定性数据.
主要成果:
- 总体上,对DR治疗的坚持率为44. 3%,轻度非增殖性DR (NPDR) 和不具有临床意义的斑点 (CSME) 的增殖性DR (PDR) 的比率更高.
- 有偿就业与DR护理的坚持有显著的积极关联 (p=0.011).
- 主要障碍包括缺乏知识 (62.8%),没有伴侣 (28.2%),时间限制 (21.8%) 和财政困难 (15.4%).
结论:
- 只有不到一半的DR患者遵守了推的治疗方法,这表明治疗的差距很大.
- 提高患者意识,支持系统的可用性和治疗费用对于改善患者的治疗效果至关重要.
- 建议采取公共卫生举措,包括社区宣传活动和改善治疗可用性,以缓解与DR相关的失明.
相关概念视频
Diabetes: Symptoms, Diagnosis, and Complications
685
For most patients, experiencing several weeks of polyuria, polydipsia, fatigue, and significant weight loss may indicate the presence of diabetes. Furthermore, adults displaying the phenotypic appearance of type 2 diabetes (particularly those who are obese and not initially insulin-requiring), may have islet cell autoantibodies, suggesting autoimmune-mediated β cell destruction and a diagnosis of latent autoimmune diabetes of adults (LADA). The categorization of glucose homeostasis is...
685
Diabetes Mellitus: Type 2 and Gestational
2.9K
Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
2.9K
Diabetes: Management and Pharmacotherapy
354
The therapy for diabetes aims to alleviate hyperglycemia-related symptoms, prevent acute metabolic decompensation, and reduce chronic end-organ complications. Glycemic control is evaluated through short-term (self-monitoring, continuous glucose monitoring) and long-term (A1c, fructosamine) metrics, enabling near real-time tracking of blood glucose levels and reflecting glycemic control over specific time frames.
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
Insulin remains the cornerstone of treatment for most patients with type 1 and many...
354
Diabetes Mellitus: Overview and Type I Subtype
3.2K
Diabetes mellitus is a chronic metabolic disorder characterized by high blood glucose levels due to inadequate insulin production, insulin resistance, or both. The condition affects millions worldwide and can significantly impact their health and quality of life.
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
Type 1 diabetes is an autoimmune disease in which the immune system mistakenly attacks and destroys the insulin-producing beta cells in the pancreas. As a result, the body is unable to produce sufficient insulin, and individuals with...
3.2K
Pathophysiology of Diabetes
1.2K
Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The four categories of diabetes are type 1 diabetes, type 2 diabetes, other specific types of diabetes, and gestational diabetes.
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
Type 1 diabetes is characterized by autoimmune-mediated destruction of pancreatic β cells, with environmental factors potentially triggering this process in genetically susceptible individuals. Despite many not having a family history, certain genes increase susceptibility,...
1.2K
Peripheral Artery Disease III: Interprofessional Care
29
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
29


