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A Study of Factors Explaining Blood Glucose Control in Patients with Insulin-treated Type 2 Diabetes

出版	King's College London, 2019
URL	http://books.google.com.hk/books?id=PVuN0AEACAAJ&hl=&source=gbs_api

註釋Findings: Of those invited, 50% (n = 201) of eligible patients, mean age 70 years (range 37-90), completed the primary survey, of which 62% (n = 124) participated in the supplemental structured telephone interviews. The mean HbA1c of the survey participants was 64 mmol/mol (SD = 16.9, range 37-168), and duration of T2DM and of insulin was 17 years (SD = 7.58) and eight years (SD = 6.15) respectively. The participants were grouped by HbA1c as follows: optimal control (HbA1c ≤59 n = 95, 47%); moderate control (HbA1c >59 to ≤69, n = 50, 25%); and suboptimal control (HbA1c >69, n = 56, 28%). A regression analysis using a dichotomised HbA1c (≤59 mmol/mol = 1 and >59 mmol/mol = 0) indicated that depression scores (Patient Health Questionnaire-9; PHQ-9) (p = .03) and diabetes duration (p = .04) were negatively and positively associated with glycaemic control, respectively. The interview data indicated that the following factors were important in moderating insulin use and its impact on glucose control: patient understanding of insulin and associated self-management behaviours; patient motivation; the expertise and support of the HCPs; and the type/level of insulin support provided by the primary care team.