上海市老年糖尿病患者血糖控制影响因素研究OA

Objective This study aims to identify the influencing factors of glycemic control among older adults aged 60 and above with diabetes in Shanghai and investigate the mediating role of nutritional status to inform personalized interventions.Methods A cross-sectional survey was conducted among permanent residents aged 60 and above in Shanghai.Data on demographics,lifestyle,care modalities,and health status were collected using the Shanghai Unified Elderly Care Needs Assessment(UECNA).Factors associated with glycemic control were analyzed via multivariate logistic regression,and the mediating effect was examined using PROCESS Model 4.Results A total of 36,101 participants were included in this study.Taking the normal glycemic group as a control,poor glycemic group was positively associated with overweight(OR=1.21,95%CI:1.05 to 1.38),underweight(OR=1.49,95%CI:1.20 to 1.85),adherence to a non-low-salt diet(OR=1.09,95%CI:1.00 to 1.18),and poor living environment hygiene(OR=1.53,95%CI:1.00 to 2.33).Other significant risk factors included malnutrition(OR=4.37,95%CI:2.85 to 6.68),poor sleep quality(OR=2.47,95%CI:1.95 to 3.12),impaired social function(OR=1.68,95%CI:1.42 to 1.99),hearing impairment(OR=1.20,95%CI:1.04 to 1.38),and severe ADL(activities of daily living)disability(OR=1.18,95%CI:1.13 to 2.92).Conversely,advanced age(≥80 years)(OR=0.77,95%CI:0.69 to 0.86),non-low-sugar or sugar-free diets(OR=0.81,95%CI:0.75 to 0.87),and living alone(OR=0.82,95%CI:0.72 to 0.94)were negatively associated with poor glycemic control.Furthermore,nutritional status mediated the relationship between two care models(informal and formal care)and glycemic control(R=0.21,95%CI:0.19 to 0.23;R=0.21,95%CI:0.19 to 0.23).This indicates that care models exert a significant indirect effect on glycemic control through the mediating variable of nutritional status,and the models are positively associated with the glycemic control.Conclusions Glycemic control in older adults with diabetes is closely associated with various factors,including demographic characteristics,dietary habits,care models,living conditions,and other health-related factors.Patients should prioritize personal hygiene and living environment hygiene,adhering to a low-salt diet,and maintaining functional independence and an appropriate BMI(body mass index).In parallel,strategic focus should be placed on complication prevention and the enhancement of caregivers'nutritional nursing competencies to optimize glycemic outcomes.