{"title":"埃塞俄比亚西北部贡达尔大学综合专科医院成年糖尿病患者首次达到最佳血糖控制的时间及相关因素:一项回顾性队列研究","authors":"Adane Desta Getahun, Emneteab Mesfin Ayele, Tilahun Degu Tsega, Sisay Sitotaw Anberbr, Gebremariam Wulie Geremew, Alemneh Ayu Biyazin, Basazinew Mekuria Taye, Gizework Alemnew Mekonnen","doi":"10.1136/bmjopen-2024-096615","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.</p><p><strong>Participants: </strong>We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.</p><p><strong>Outcome measures: </strong>The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.</p><p><strong>Results: </strong>Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.</p><p><strong>Conclusion: </strong>The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.</p>","PeriodicalId":9158,"journal":{"name":"BMJ Open","volume":"15 9","pages":"e096615"},"PeriodicalIF":2.3000,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496110/pdf/","citationCount":"0","resultStr":"{\"title\":\"Time to first optimal glycaemic control and associated factors among adult patients with diabetes at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia: a retrospective cohort study.\",\"authors\":\"Adane Desta Getahun, Emneteab Mesfin Ayele, Tilahun Degu Tsega, Sisay Sitotaw Anberbr, Gebremariam Wulie Geremew, Alemneh Ayu Biyazin, Basazinew Mekuria Taye, Gizework Alemnew Mekonnen\",\"doi\":\"10.1136/bmjopen-2024-096615\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.</p><p><strong>Participants: </strong>We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.</p><p><strong>Outcome measures: </strong>The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.</p><p><strong>Results: </strong>Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.</p><p><strong>Conclusion: </strong>The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.</p>\",\"PeriodicalId\":9158,\"journal\":{\"name\":\"BMJ Open\",\"volume\":\"15 9\",\"pages\":\"e096615\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12496110/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"BMJ Open\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1136/bmjopen-2024-096615\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMJ Open","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1136/bmjopen-2024-096615","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
目的:评估埃塞俄比亚贡达尔大学综合专科医院1型和2型糖尿病成人患者首次达到最佳血糖控制的时间及其预测因素。设计:回顾性队列研究。地点:埃塞俄比亚西北部贡达尔大学综合专科医院。参与者:我们招募了423名成年糖尿病患者,他们于2018年1月1日至2022年12月30日在贡达尔大学综合专科医院被诊断出来。结局指标:主要结局是从诊断到实现第一次最佳血糖控制的时间,以月为单位。采用Cox比例风险回归模型确定首次达到最佳血糖控制所需时间的预测因子。使用KoboToolbox从患者病历中收集数据,并导出到Stata V.17。对数秩检验用于确定参与者亚组之间的生存差异。结果:首次达到最佳血糖控制的中位时间为10.6个月。423例成人糖尿病患者中,301例(71.16%)在研究期间达到第一次最佳血糖控制。年龄类别(中年(校正HR (AHR)=0.56, 95% CI 0.41 ~ 0.76)、老年(AHR=0.52, 95% CI 0.33 ~ 0.82)、合共病(AHR=0.52, 95% CI 0.35 ~ 0.76)、治疗惯性(AHR=0.20, 95% CI 0.13 ~ 0.30)和药物不依从性(AHR=0.49, 95% CI 0.27 ~ 0.89)是达到最佳血糖控制所需时间的显著预测因子。结论:达到首次最佳血糖控制的中位时间延长。糖尿病护理应注重控制已确定的预测因素,以便在诊断后早期实现最佳的血糖控制。
Time to first optimal glycaemic control and associated factors among adult patients with diabetes at the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia: a retrospective cohort study.
Objective: To assess the time to first optimal glycaemic control and its predictors among adult patients with type 1 and type 2 diabetes at the University of Gondar Comprehensive Specialized Hospital in Ethiopia.
Design: A retrospective cohort study.
Setting: University of Gondar Comprehensive Specialized Hospital, northwest, Ethiopia.
Participants: We recruited 423 adult diabetic patients who were diagnosed between 1 January 2018 and 30 December 2022 at the University of Gondar Comprehensive Specialized Hospital.
Outcome measures: The primary outcome was the time from diagnosis to the achievement of the first optimal glycaemic control, measured in months. A Cox proportional hazards regression model was fitted to identify predictors of time to first optimal glycaemic control. Data were collected with KoboToolbox from patient medical charts and exported to Stata V.17. The log-rank test was used to determine the survival difference between subgroups of participants.
Results: Median time to first optimal glycaemic control was 10.6 months. Among 423 adult diabetic patients, 301 (71.16%) achieved the first optimal glycaemic control during the study period. Age category (middle age (adjusted HR (AHR)=0.56, 95% CI 0.41 to 0.76), older age (AHR=0.52, 95% CI 0.33 to 0.82)), comorbidity (AHR=0.52, 95% CI 0.35 to 0.76), therapeutic inertia (AHR=0.20, 95% CI 0.13 to 0.30) and medication non-compliance (AHR=0.49, 95% CI 0.27 to 0.89) were significant predictors of time to optimal glycaemic control.
Conclusion: The median time to first optimal glycaemic control was prolonged. Diabetic care should focus on controlling the identified predictors to achieve optimal glycaemic control early after diagnosis.
期刊介绍:
BMJ Open is an online, open access journal, dedicated to publishing medical research from all disciplines and therapeutic areas. The journal publishes all research study types, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Publishing procedures are built around fully open peer review and continuous publication, publishing research online as soon as the article is ready.