Nor Izyani Bahari, Norfazilah Ahmad, Muhammad Hilmi Mahmud, Mazni Baharom, Siti Maisara Amir, Chua Su Peng, Mohd Rohaizat Hassan, Azmawati Mohammed Nawi
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引用次数: 1
Abstract
Background: Primary prevention of type 2 diabetes mellitus (T2DM) is possible in at-risk populations, and prevention programmes have been shown to be effective in real-world scenarios. Despite this evidence, diabetes prevalence has tripled in recent decades and is expected to reach 700 million patients by 2045, making it one of the leading causes of death globally. This review is aimed at identifying the issues and challenges in the primary prevention of T2DM.
Methods: Scopus, Web of Science, PubMed and Ovid MEDLINE were systematically searched for published articles. Articles were screened based of inclusion and exclusion criteria. The inclusion criteria were: (1) published in 2010-2020, (2) full original article, (3) written in English, (4) qualitative, mixed-methods article, observational or interventional study. The exclusion criteria were: (1) animal study, (2) in vivo/in vitro study, (3) type 1 diabetes or gestational DM and (4) conference abstract, book chapter, report, and systematic review. Eligible articles were assessed using Mixed Methods Appraisal Tool (MMAT) by three assessors.
Results: A total of 11 articles were selected for qualitative synthesis from the initial 620 articles. The issues and challenges seen in T2DM primary prevention followed three themes: healthcare program (sub-themes: lack of resources, community partnership, participation, health literacy), health provider (sub-themes: lack of implementation, health care staff, collaboration, availability), individual (sub-themes: awareness, communication, misbehaviour, family conflict).
Conclusion: Factors relating to healthcare programmes, health providers, and individual issues are the main challenges in T2DM primary prevention. By establishing sustainable preventative initiatives that address these issues and challenges in the primary prevention of T2DM, a reduction in T2DM prevalence could be achievable.
背景:在高危人群中,2型糖尿病(T2DM)的一级预防是可能的,并且在现实世界中,预防方案已被证明是有效的。尽管有这些证据,近几十年来,糖尿病患病率增加了两倍,预计到2045年将达到7亿患者,使其成为全球主要死亡原因之一。本综述旨在确定T2DM一级预防中的问题和挑战。方法:系统检索Scopus、Web of Science、PubMed、Ovid MEDLINE等已发表文章。根据纳入和排除标准对文章进行筛选。纳入标准为:(1)发表于2010-2020年,(2)全文原创文章,(3)英文论文,(4)定性、混合方法研究,观察性或干预性研究。排除标准为:(1)动物研究,(2)体内/体外研究,(3)1型糖尿病或妊娠期糖尿病,(4)会议摘要、书籍章节、报告和系统评价。符合条件的文章由三名评估员使用混合方法评估工具(MMAT)进行评估。结果:从最初的620篇文章中筛选出11篇进行定性合成。2型糖尿病初级预防面临的问题和挑战有三个主题:保健方案(分主题:缺乏资源、社区伙伴关系、参与、卫生知识普及)、保健提供者(分主题:缺乏实施、保健工作人员、协作、可用性)、个人(分主题:意识、沟通、行为不当、家庭冲突)。结论:与卫生保健方案、卫生保健提供者和个人问题相关的因素是T2DM一级预防的主要挑战。通过建立可持续的预防措施,解决T2DM一级预防中的这些问题和挑战,可以实现T2DM患病率的降低。