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Use and Impact of Type 2 Diabetes Prevention Interventions
被引:11
作者:
Campione, Joanne R.
[1
]
Ritchie, Natalie D.
[2
]
Fishbein, Howard A.
[3
]
Mardon, Russell E.
[3
]
Johnson, Maurice C., Jr.
[3
]
Pace, Wilson
[4
]
Birch, Rebecca Jeffries
[3
]
Seeholzer, Eileen L.
[5
]
Zhang, Xuanping
[6
]
Proia, Krista
[6
]
Siegel, Karen R.
[6
]
Bullard, Kai McKeever
[6
]
机构:
[1] Westat Corp, 2530 Meridian Pkwy,Suite 200, Durham, NC 27703 USA
[2] Denver Hlth & Hosp Author, Off Res, Denver, CO USA
[3] Westat Corp, Rockville, MD USA
[4] DARTNet Inst, Aurora, CO USA
[5] MetroHlth, Cleveland, OH USA
[6] Ctr Dis Control & Prevent, Atlanta, GA USA
关键词:
LIFE-STYLE INTERVENTION;
WEIGHT-LOSS;
FOLLOW-UP;
REDUCTION;
PROGRAM;
METFORMIN;
D O I:
10.1016/j.amepre.2022.04.002
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Introduction: RCTs have found that type 2 diabetes can be prevented among high-risk individuals by metformin medication and evidence-based lifestyle change programs. The purpose of this study is to estimate the use of interventions to prevent type 2 diabetes in real-world clinical practice set-tings and determine the impact on diabetes-related clinical outcomes. Methods: The analysis performed in 2020 used 2010-2018 electronic health record data from 69,434 patients aged >= 18 years at high risk for type 2 diabetes in 2 health systems. The use and impact of prescribed metformin, lifestyle change program, bariatric surgery, and combinations of the 3 were examined. A subanalysis was performed to examine uptake and retention among patients referred to the National Diabetes Prevention Program. Results: Mean HbA1c values declined from before to after intervention for patients who were pre-scribed metformin (-0.067%; p < 0.001) or had bariatric surgery (-0.318%; p < 0.001). Among patients referred to the National Diabetes Prevention Program lifestyle change program, the type 2 diabetes postintervention incidence proportion was 14.0% for nonattendees, 12.8% for some attendance, and 7.5% for those who attended >= 4 sessions (p < 0.001). Among referred patients to the National Diabetes Prevention Program lifestyle change program, uptake was low (13% for 1-3 sessions, 15% for >= 4 sessions), especially among males and Hispanic patients. Conclusions: Findings suggest that metformin and bariatric surgery may improve HbA1c levels and that participation in the National Diabetes Prevention Program may reduce type 2 diabetes incidence. Efforts to increase the use of these interventions may have positive impacts on diabetes -related health outcomes. (C) 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.
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页码:603 / 610
页数:8
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