Abstract:Objective To explore the influencing factors of type 2 diabetes mellitus (T2DM) complicated with diabetic kidney disease (DKD) microalbuminuria. Methods A total of 308 T2DM patients from two tertiary A hospitals in Hengyang City from August 2020 to April 2021 as the research objects. Patients were divided into groups according to the occurrence of microalbuminuria, urinary albumin excretion rate (UAER) of 30-300 mg/24 h was included in the DKD group, UAER<30 mg/24 h was included in the non-DKD group. The influencing factors of DKD in T2DM patients were analyzed by binary logistic regression. Results Among 308 T2DM patients in this study, 136 (44.16%) were DKD microalbuminuria patients and 172 (55.84%) were non-DKD microalbuminuria patients. Univariate analysis showed that age, duration of diabetes, systolic blood pressure, diastolic blood pressure, low density lipoprotein cholesterol (LDL-C),fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), proportion of history of hypertension and proportion of abdominal obesity in DKD group were higher than those in non-DKD group, self-efficacy score and health promotion lifestyle score in DKD group were lower than those of non-DKD group, and the differences were statistically significant(P<0.05). The results of binary logistic regression analysis showed that the course of diabetes mellitus (β=0.055, OR=1.057, 95%CI=1.007-1.109), systolic blood pressure (β=0.039, OR=1.040, 95%CI=1.016-1.064), LDL-C (β=0.333,OR=1.395, 95%CI=1.017-1.914), abdominal obesity(β=0.596, OR=1.815, 95%CI=1.039-3.171), HbA1c(β=0.182, OR=1.199, 95%CI=1.071-1.344) were risk factors for DKD microalbuminuria in T2DM patients (P<0.05), health promotion lifestyle score (β=-0.018, OR=0.983, 95%CI=0.967-0.998), self-efficacy score (β=-0.029, OR=0.972, 95%CI=0.948-0.996) was protective factors for DKD microalbuminuria in T2DM patients (P<0.05). Conclusion With the prolonged duration of the course of diabetes mellitus and poor glycaemic control, T2DM patients are prone to kidney disease. Nurses should pay attention to improving the self-efficacy of the patients, advocating a health-promoting lifestyle, which can help prevent or delay the occurrence of microalbuminuria of diabetic kidney disease.
Li Y,Teng D,Shi X,et al.Prevalence of diabetes recorded in mainland China using 2018 diagnostic criteria from the American Diabetes Association:national cross sectional study[J].BMJ,2020,369:m997.
[2]
Afkarian M,Zelnick LR,Hall YN,et al.Clinical Manifestations of Kidney Disease Among US Adults With Diabetes,1988-2014[J].JAMA,2016,316(6):602-610.
[3]
Zhang L,Long J,Jiang W,et al.Trends in Chronic Kidney Disease in China[J].N Engl J Med,2016,375(9):905-906.
[4]
Dagar N,Das P,Bisht P,et al.Diabetic nephropathy:A twisted thread to unravel[J].Life Sci,2021,278:119635.
Kara M,van der Bijl JJ,Shortridge-Baggett LM,et al.Crosscultural adaptation of the Diabetes Management Self-Efficacy Scale for patients with type 2 diabetes mellitus:scale development[J].Int J Nurs Stud,2006,43(5):611-621.
Chen C,Peng Y,Weng H,et al.Development and preliminary testing of a brief screening measure of healthy lifestyle for diabetes patients[J].Int J Nurs Stud,2013,50(1):90-99.
[12]
Retnakaran R,Cull CA,Thorne KI,et al.Risk factors for renal dysfunction in type 2 diabetes:U.K. Prospective Diabetes Study 74[J].Diabetes,2006,55(6):1832-1839.
[13]
Xi C,Wang C,Rong G,et al.A Nomogram Model that Predicts the Risk of Diabetic Nephropathy in Type 2 Diabetes Mellitus Patients:A Retrospective Study[J].Int J Endocrinol,2021,2021:6672444.
[16]
Wang X,Li J,Huo L,et al.Clinical characteristics of diabetic nephropathy in patients with type 2 diabetic mellitus manifesting heavy proteinuria:A retrospective analysis of 220 cases[J].Diabetes Res Clin Pract,2019,157:107874.
[17]
Duan J,Wang C,Liu D,et al.Prevalence and risk factors of chronic kidney disease and diabetic kidney disease in Chinese rural residents:a cross-sectional survey[J].Sci Rep,2019,9(1):10 408.
Lyu QY,Huang JW,Li YX,et al.Effects of a nurse led web-based transitional care program on the glycemic control and quality of life post hospital discharge in patients with type 2 diabetes:A randomized controlled trial[J].Int J Nurs Stud,2021,119:103929.