ผลของการดูแลผู้ป่วยในคลินิกเบาหวานโดยทีมสหสาขาวิชาชีพต่อการชะลอการเสื่อมของไต

บทคัดย่อ

A descriptive analytic study was aimed to determine the impact of patients care team’ s intervention on renal deterioration in diabetic clinic during February 1^st, 2009 and January 31^th, 2010. There were two periods of data collection; the first was early 7-month period which there was not patients care team’ s intervention and the second was late 5-month period which patients care team’ s intervention took effect. We used Cockcroft-Gault (CG) formula and Modification of Diet in Renal Disease (MDRD) formula to assess renal function. There were 99 diabetic patients, mostly female (79%). Average age was 63.1 years. The results showed no difference between deterioration rate of renal function before and after the intervention (-3.16 ± 10.73 and -9.22 ± 34.56 ml/min/1.73 m²/year by CG formula; -4.13 ± 14.04 and -4.44 ± 34.13 ml/min/1.73 m²/year by MDRD formula; p > 0.05 both). However, there were statistically significant differences among fasting plasma glucose (146.2 ± 47.8 and 125.2 ± 31.7 mg/dL; p < 0.001), HbA1c (8.3 ± 1.2 and 7.7 ± 1.0 g/dL; p < 0.001), systolic blood pressure (136.4 ± 13.3 and 127.9 v 9.1 mmHg; p < 0.001), diastolic blood pressure (76.9 ± 8.0 and 74.4 ± 6.2 mmHg; p < 0.01) and cholesterol (232.7 ± 47.4 and 9.3 ± 26.1 mg/dl; p < 0.001). In conclusion, the patients care team’ s intervention was crucial for a medical care in diabetic clinic but we can still not demonstrate the affect on renal deterioration.