請用此 Handle URI 來引用此文件：
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/72648完整後設資料紀錄
| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 董鈺琪(Yu-Chi Tung) | |
| dc.contributor.author | Ya-An Tsai | en |
| dc.contributor.author | 蔡雅安 | zh_TW |
| dc.date.accessioned | 2021-06-17T07:02:43Z | - |
| dc.date.available | 2024-08-27 | |
| dc.date.copyright | 2019-08-27 | |
| dc.date.issued | 2019 | |
| dc.date.submitted | 2019-07-30 | |
| dc.identifier.citation | 1. Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011;94:311-21. doi: 10.1016/j.diabres.2011.10.029.
2. 衛生福利部國民健康署. 106年死因統計結果分析. 2018. 3. 方毓健, 陳志宇, 林俐妏. 糖尿病與牙周病間相互影響的關係. 臺灣牙周病醫學會雜誌 2009;14:277-91. 4. 呂昆龍, 沈一慶, 黃國光. 超音波器械在牙周病治療與人工植牙手術的應用. 臺灣牙周病醫學會雜誌 2010;15:231-43. 5. Periodontology AAo. Guideline for periodontal therapy. Available at: http://www.aapd.org/media/Policies_Guidelines/E_PerioTherapy.pdf. Accessed 2019/01/13, 2019. 6. Costa KL, Taboza ZA, Angelino GB, et al. Influence of Periodontal Disease on Changes of Glycated Hemoglobin Levels in Patients With Type 2 Diabetes Mellitus: A Retrospective Cohort Study. J Periodontol 2017;88:17-25. doi: 10.1902/jop.2016.160140. 7. Merchant AT, Georgantopoulos P, Howe CJ, Virani SS, Morales DA, Haddock KS. Effect of Long-Term Periodontal Care on Hemoglobin A1c in Type 2 Diabetes. J Dent Res 2016;95:408-15. doi: 10.1177/0022034515622197. 8. Salman S, Khan K, Salman F, Hameed M. Effect Of Non- Surgical Periodontal Treatment On Glycemic Control Among Type 2 Diabetes Mellitus Patients With Periodontitis. J Ayub Med Coll Abbottabad 2016;28:442-5. 9. Teeuw WJ, Gerdes VE, Loos BG. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes Care 2010;33:421-7. doi: 10.2337/dc09-1378. 10. Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Periodontol 2013;84:S153-69. doi: 10.1902/jop.2013.1340017. 11. Sgolastra F, Severino M, Pietropaoli D, Gatto R, Monaco A. Effectiveness of periodontal treatment to improve metabolic control in patients with chronic periodontitis and type 2 diabetes: a meta-analysis of randomized clinical trials. J Periodontol 2013;84:958-73. doi: 10.1902/jop.2012.120377. 12. Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 2005;84:1154-9. doi: 10.1177/154405910508401212. 13. Engebretson SP, Hyman LG, Michalowicz BS, et al. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA 2013;310:2523-32. doi: 10.1001/jama.2013.282431. 14. 行政院衛生署國民健康局, 中華民國糖尿病學會. 糖尿病防治手冊. 2003. 15. 黃蘭菁, 李貫廷, 李育霖, 楊偉勛, 黃國晉. 2013年美國糖尿病學會臨床治療指引摘要. 台北市醫師公會會刊 2013;57:9. 16. 賴昭翰, 呂炫堃. 牙周炎和糖尿病在臺灣盛行狀況與東西方流行病學文獻回顧. 臺灣牙周病醫學會雜誌 2015;20:103-18. doi: 10.6121/tap.2015.20.2.04. 17. Genuth S, Eastman R, Kahn R, et al. Implications of the United kingdom prospective diabetes study. Diabetes Care 2003;26 Suppl 1:S28-32. 18. American Diabetes A. 6. Glycemic Targets: Standards of Medical Care in Diabetes-2019. Diabetes Care 2019;42:S61-S70. doi: 10.2337/dc19-S006. 19. 黃憶玫, 張慈桂. 糖尿病照護成效與影響因素之探討：以台東某區域醫院糖尿病共同照護網為例. 台灣公共衛生雜誌 2011;30:19-28. doi: 10.6288/tjph2011-30-01-03. 20. ADA. eAG/A1C Conversion Calculator. Available at: https://professional.diabetes.org/diapro/glucose_calc. Accessed 2019/06/16, 2019. 21. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008;88:1254-64. doi: 10.2522/ptj.20080020. 22. 周碧瑟, 董道興, 李佳琳, 莊紹源, 林敬恆, 楊南屏. 台灣地區糖尿病流行病學. 台灣公共衛生雜誌 2002;21:83-96. doi: 10.6288/tjph2002-21-02-01. 23. 社團法人中華民國糖尿病協會. 2018 糖尿病臨床照護指引2018. 24. King KD, Jones JD, Warthen J. Microvascular and Macrovascular Complications of Diabetes Mellitus. American Journal of Pharmaceutical Education 2005;69:87. doi: 10.5688/aj690587. 25. Chang CJ, Fu CC, Chen MS, et al. A comparison of newly and previously diagnosed diabetics in Taiwan. Journal of the Formosan Medical Association = Taiwan yi zhi 1990;89:264-9. 26. Chen M-S, Kao C-S, Chang C-J, et al. Prevalence and Risk Factors of Diabetic Retinopathy Among Noninsulin-dependent Diabetic Subjects. American Journal of Ophthalmology 1992;114:723-30. doi: https://doi.org/10.1016/S0002-9394(14)74051-6. 27. Williams RC. Periodontal disease. N Engl J Med 1990;322:373-82. doi: 10.1056/NEJM199002083220606. 28. Pihlstrom BL, Michalowicz BS, Johnson NW. Periodontal diseases. Lancet 2005;366:1809-20. doi: 10.1016/S0140-6736(05)67728-8. 29. Albandar JM, Rams TE. Global epidemiology of periodontal diseases: an overview. Periodontol 2000 2002;29:7-10. 30. Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Periodontol 2018;89 Suppl 1:S1-S8. doi: 10.1002/JPER.18-0157. 31. Tonetti MS, Sanz M. Implementation of the new classification of periodontal diseases: Decision-making algorithms for clinical practice and education. J Clin Periodontol 2019;46:398-405. doi: 10.1111/jcpe.13104. 32. Murakami S, Mealey BL, Mariotti A, Chapple ILC. Dental plaque-induced gingival conditions. J Periodontol 2018;89 Suppl 1:S17-S27. doi: 10.1002/JPER.17-0095. 33. Hatem AE. Epidemiology and risk factors of periodontal disease. Periodontal Diseases-A Clinician's Guide: IntechOpen, 2012. 34. Genco RJ. Current View of Risk Factors for Periodontal Diseases. J Periodontol 1996;67 Suppl 10S:1041-9. doi: 10.1902/jop.1996.67.10s.1041. 35. 賴弘明. 臺灣社群牙周病情況與面臨之挑戰. 臺灣牙周病醫學會雜誌 2013;18:177-92. doi: 10.6121/tap.2013.18.3.02. 36. 蔡吉政. 瞭解牙周病的病因. 臺灣口腔醫學會雜誌 2000;16:341-2. doi: 10.7059/jafs.200012.0341. 37. Torrungruang K, Tamsailom S, Rojanasomsith K, et al. Risk indicators of periodontal disease in older Thai adults. J Periodontol 2005;76:558-65. doi: 10.1902/jop.2005.76.4.558. 38. 衛生福利部中央健康保險署. 107年全民健康保險牙醫門診總額牙周病統合照護計畫.2019. 39. 中華民國牙醫師公會全國聯合會. 牙周病統合照護計畫照護手冊. 3 ed2014. 40. Heitz-Mayfield LJ, Trombelli L, Heitz F, Needleman I, Moles D. A systematic review of the effect of surgical debridement vs non-surgical debridement for the treatment of chronic periodontitis. J Clin Periodontol 2002;29 Suppl 3:92-102; discussion 60-2. 41. 衛生福利部中央健康保險署. 全民健康保險醫療服務給付項目及支付標準第三部 牙醫. 42. Polak D, Shapira L. An update on the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol 2018;45:150-66. doi: 10.1111/jcpe.12803. 43. Nilo Guliberto Martins Chávarry, Mario Vianna Vettorec, Carmelo Sansonea, Sheihamd A. The Relationship Between Diabetes Mellitus and Destructive Periodontal Disease: A Meta-Analysis. Oral Health Prev Dent 2009;7:107-27. 44. 謝宗穎, 呂雅媛, 杜裕康. 劑量與效應反應的統合分析之應用：以血糖值與牙周病間的關係為例. 台灣公共衛生雜誌 2015;34:521-33. doi: 10.6288/tjph201534104010. 45. Bastos AS, Graves DT, Loureiro APdM, et al. Lipid Peroxidation Is Associated with the Severity of Periodontal Disease and Local Inflammatory Markers in Patients with Type 2 Diabetes. The Journal of Clinical Endocrinology & Metabolism 2012;97:E1353-E62. doi: 10.1210/jc.2011-3397. 46. Duarte PM, Bezerra JP, Miranda TS, Feres M, Chambrone L, Shaddox LM. Local levels of inflammatory mediators in uncontrolled type 2 diabetic subjects with chronic periodontitis. Journal of Clinical Periodontology 2014;41:11-8. doi: 10.1111/jcpe.12179. 47. Lalla E, Lamster IB, Schmidt AM. Enhanced interaction of advanced glycation end products with their cellular receptor RAGE: implications for the pathogenesis of accelerated periodontal disease in diabetes. Ann Periodontol 1998;3:13-9. doi: 10.1902/annals.1998.3.1.13. 48. Lalla E, Lamster IB, Feit M, et al. Blockade of RAGE suppresses periodontitis-associated bone loss in diabetic mice. J Clin Invest 2000;105:1117-24. doi: 10.1172/JCI8942. 49. SAMMALKORPI K. Glucose intolerance in acute infections. Journal of Internal Medicine 1989;225:15-9. doi: 10.1111/j.1365-2796.1989.tb00030.x. 50. Shoelson SE, Lee J, Goldfine AB. Inflammation and insulin resistance. The Journal of Clinical Investigation 2006;116:1793-801. doi: 10.1172/JCI29069. 51. Taylor GW. Bidirectional Interrelationships Between Diabetes and Periodontal Diseases: An Epidemiologic Perspective. Annals of Periodontology 2001;6:99-112. doi: 10.1902/annals.2001.6.1.99. 52. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two-way relationship. Ann Periodontol 1998;3:51-61. doi: 10.1902/annals.1998.3.1.51. 53. Engebretson S, Chertog R, Nichols A, Hey-Hadavi J, Celenti R, Grbic J. Plasma levels of tumour necrosis factor-α in patients with chronic periodontitis and type 2 diabetes. Journal of Clinical Periodontology 2007;34:18-24. doi: 10.1111/j.1600-051X.2006.01017.x. 54. Argiles JM, Lopez-Soriano J, Lopez-Soriano FJ. Cytokines and diabetes: the final step? Involvement of TNF-alpha in both type I and II diabetes mellitus. Horm Metab Res 1994;26:447-9. 55. Thorstensson H, Kuylenstiema J, Hugoson A. Medical Status and complications in relation to periodontal disease experience in insulin-dependent diabetics. Journal of Clinical Periodontology 1996;23:194-202. doi: 10.1111/j.1600-051X.1996.tb02076.x. 56. Shultis WA, Weil EJ, Looker HC, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care 2007;30:306-11. doi: 10.2337/dc06-1184. 57. 陳滋茨, 張媚, 林豔君. 自我效能、社會支持與糖尿病病人居家自我照顧行為相關之探討. 護理研究 1998;6:31-43. doi: 10.7081/nr.199802.0031. 58. 黃美娟, 林麗娟, 洪志秀. 第二型糖尿病患自我照顧行爲及其相關因素之探討. 長期照護雜誌 2008;12:191-201. 59. Ng TP, Goh LG, Tan Y, et al. Ethnic differences in glycaemic control in adult Type 2 diabetic patients in primary care: a 3-year follow-up study. Diabet Med 2005;22:1598-604. doi: 10.1111/j.1464-5491.2005.01759.x. 60. Benoit SR, Fleming R, Philis-Tsimikas A, Ji M. Predictors of glycemic control among patients with Type 2 diabetes: A longitudinal study. BMC Public Health 2005;5:36. doi: 10.1186/1471-2458-5-36. 61. Bruce DG, Davis WA, Cull CA, Davis TM. Diabetes education and knowledge in patients with type 2 diabetes from the community: the Fremantle Diabetes Study. J Diabetes Complications 2003;17:82-9. 62. Rono K, Masalin S, Kautiainen H, et al. Impact of maternal income on the risk of gestational diabetes mellitus in primiparous women. Diabet Med 2018. doi: 10.1111/dme.13834. 63. 張順全, 賴美淑, 徐豈庸. 台灣地理區域社經差異與糖尿病患罹病、死亡的關聯性探討. 醫護科技學刊 2005;7:140-8. doi: 10.6563/tjhs.2005.7(2).3. 64. 蔡政麟, 葉玲玲, 楊志良, 孫培然. 納入糖尿病共同照護網後影響病患遵醫囑行為之研究－以某區域教學醫院為例. 童綜合醫學雜誌 2007;1:11-22. doi: 10.29838/tmj.200712.0003. 65. Garcia D, Tarima S, Okunseri C. Periodontitis and glycemic control in diabetes: NHANES 2009 to 2012. J Periodontol 2015;86:499-506. doi: 10.1902/jop.2014.140364. 66. Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Periodontol 2013;84:S113-34. doi: 10.1902/jop.2013.134005. 67. Agwunobi AO, Reid C, Maycock P, Little RA, Carlson GL. Insulin resistance and substrate utilization in human endotoxemia. J Clin Endocrinol Metab 2000;85:3770-8. doi: 10.1210/jcem.85.10.6914. 68. Grossi SG, Skrepcinski FB, DeCaro T, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol 1997;68:713-9. doi: 10.1902/jop.1997.68.8.713. 69. Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF. Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol 2003;74:1361-7. doi: 10.1902/jop.2003.74.9.1361. 70. Chapple IL, Genco R. Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. J Periodontol 2013;84:S106-12. doi: 10.1902/jop.2013.1340011. 71. Mauri-Obradors E, Jane-Salas E, Sabater-Recolons Mdel M, Vinas M, Lopez-Lopez J. Effect of nonsurgical periodontal treatment on glycosylated hemoglobin in diabetic patients: a systematic review. Odontology 2015;103:301-13. doi: 10.1007/s10266-014-0165-2. 72. Mosen DM, Pihlstrom DJ, Snyder JJ, Shuster E. Assessing the association between receipt of dental care, diabetes control measures and health care utilization. J Am Dent Assoc 2012;143:20-30. 73. Nasseh K, Vujicic M, Glick M. The Relationship between Periodontal Interventions and Healthcare Costs and Utilization. Evidence from an Integrated Dental, Medical, and Pharmacy Commercial Claims Database. Health Econ 2017;26:519-27. doi: 10.1002/hec.3316. 74. 冼裕程. 糖尿病論質計酬對醫療利用與照護成效之影響. 醫院管理與醫事行政 2011:1-115. doi: 10.6833/cjcu.2011.00051. 75. Miller DR, Safford MM, Pogach LM. Who has diabetes? Best estimates of diabetes prevalence in the Department of Veterans Affairs based on computerized patient data. Diabetes Care 2004;27 Suppl 2:B10-21. 76. 蔡明足, 翁林仲, 蔡維河, et al. 台灣地區糖尿病病患及其視網膜病變的醫療資源耗用. 台灣公共衛生雜誌 2008;27:101-9. doi: 10.6288/tjph2008-27-02-02. 77. 衛生福利部中央健康保險署. 全民健康保險醫療服務給付項目及支付標準第八部第二章 糖尿病. 78. 柯玲晶, 譚醒朝, 譚家惠. Charlson合併症指數對全民健康保險資料庫適用性之探討. 台灣公共衛生雜誌 2007;26:491-8. doi: 10.6288/tjph2007-26-06-06. 79. 朱育增, 吳肖琪, 李玉春, 賴美淑, 譚醒朝. 探討共病測量方法於健保次級資料之應用. 台灣公共衛生雜誌 2010;29:191-200. doi: 10.6288/tjph2010-29-03-01. 80. 朱育增, 吳肖琪. 回顧與探討次級資料適用之共病測量方法. 台灣公共衛生雜誌 2010;29:8-21. doi: 10.6288/tjph2010-29-01-02. 81. Quan H, Sundararajan V, Halfon P, et al. Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data. Med Care 2005;43:1130-9. 82. Young BA, Lin E, Von Korff M, et al. Diabetes complications severity index and risk of mortality, hospitalization, and healthcare utilization. The American journal of managed care 2008;14:15-23. 83. Glasheen WP, Renda A, Dong Y. Diabetes Complications Severity Index (DCSI)-Update and ICD-10 translation. J Diabetes Complications 2017;31:1007-13. doi: 10.1016/j.jdiacomp.2017.02.018. 84. 劉介宇, 洪永泰, 莊義利, et al. 台灣地區鄉鎮市區發展類型應用於大型健康調查抽樣設計之研究. 健康管理學刊 2006;4:1-22. doi: 10.29805/jhm.200606.0001. 85. Ju X, Spencer AJ, Brennan DS. Dentist age, period and cohort effects on provision of dental services in Australia: 1983-84 to 2009-10. Community Dent Oral Epidemiol 2017;45:242-50. doi: 10.1111/cdoe.12282. 86. 林文德, 謝其政, 邱尚志, 吳慧俞, 黃一展. 以傾向分數配對法評估糖尿病論質計酬方案之成效. 台灣公共衛生雜誌 2010;29:54-63. doi: 10.6288/tjph2010-29-01-06. 87. D'Agostino RB, Jr. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med 1998;17:2265-81. 88. Milward MR, Chapple IL. Classification of periodontal diseases: where were we? Where are we now? Where are we going? Dent Update 2003;30:37-44. doi: 10.12968/denu.2003.30.1.37. 89. Sun WL, Chen LL, Zhang SZ, Wu YM, Ren YZ, Qin GM. Inflammatory cytokines, adiponectin, insulin resistance and metabolic control after periodontal intervention in patients with type 2 diabetes and chronic periodontitis. Intern Med 2011;50:1569-74. 90. Paraskevas S, Huizinga JD, Loos BG. A systematic review and meta-analyses on C-reactive protein in relation to periodontitis. J Clin Periodontol 2008;35:277-90. doi: 10.1111/j.1600-051X.2007.01173.x. 91. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405-12. doi: 10.1136/bmj.321.7258.405. 92. Cooper ME. Major findings from the ADVANCE study: glucose-lowering arm. Medicographia 2009;31:6. 93. Niefeld MR, Braunstein JB, Wu AW, Saudek CD, Weller WE, Anderson GF. Preventable hospitalization among elderly Medicare beneficiaries with type 2 diabetes. Diabetes Care 2003;26:1344-9. 94. Bui LP, Hill-Briggs F, Durkin N, et al. Does an all-condition case management program for high-risk patients reduce health care utilization in medicaid and medicare beneficiaries with diabetes? J Diabetes Complications 2019;33:445-50. doi: 10.1016/j.jdiacomp.2018.12.011. 95. 李守義, 周碧瑟, 晏涵文. 健康信念模式的回顧與前瞻. 中華民國公共衛生學會雜誌 1989;9:123-37. doi: 10.6288/jnpharc1989-09-03-02. 96. Newman JF, Gift HC. Regular pattern of preventive dental services—A measure of access. Social Science & Medicine 1992;35:997-1001. doi: https://doi.org/10.1016/0277-9536(92)90239-M. 97. Rosen M. Dental treatment: utilization, motivation and prevention. A behavioural study of why people seek dental care. J Dent Assoc S Afr 1990;45:319-21. 98. Yong PH, Weinberg L, Torkamani N, et al. The Presence of Diabetes and Higher HbA1c Are Independently Associated With Adverse Outcomes After Surgery. Diabetes Care 2018;41:1172-9. doi: 10.2337/dc17-2304. 99. Huang Y, Zheng H, Chen P, et al. An Elevated HbA1c Level Is Associated With Short-Term Adverse Outcomes in Patients With Gastrointestinal Cancer and Type 2 Diabetes Mellitus. J Clin Med Res 2017;9:303-9. doi: 10.14740/jocmr2607w. 100. Segal L, Nguyen H, Schmidt B, Wenitong M, McDermott RA. Economic evaluation of Indigenous health worker management of poorly controlled type 2 diabetes in north Queensland. Med J Aust 2016;204:1961e-9. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/72648 | - |
| dc.description.abstract | 背景：對於第二型糖尿病患而言，有伴隨嚴重牙周病其糖化血色素(HbA1c)會顯著上升，進行非手術性牙周治療介入，則可以降低HbA1c值。然國外有關糖尿病與牙周治療介入之相關實證研究結果存在不一致性，且目前國內尚缺乏相關大型研究資料。
目的：探討第二型糖尿病伴隨有牙周病的病人，其以牙結石清除或齒齦下刮除術治療介入後，後續對於糖尿病照護結果與醫療利用之間的關係。 方法：採回溯性世代研究設計以全民健康保險資料庫進行次級資料分析，使用2017年診斷為第二型糖尿病伴隨有牙周病的病人為研究對象，透過傾向分數配對法降低干擾作用，了解其有無接受牙周治療介入，其對於2018年糖尿病照護結果與醫療利用之差異。 結果：以牙結石清除或齒齦下刮除術治療介入後，相較沒接受治療者：其後續HbA1c控制在7%以內的勝算比為1.065倍、減少13%腎臟病變風險、減少27%住院風險；西醫門診次數、牙醫門診次數及牙醫總醫療費用上升；平均住院天數、住院總醫療費用及總體(含門住診)醫療費用下降。 結論與建議：有牙周病的第二型糖尿病患有接受牙周治療者，其後續糖尿病照護結果較佳，住院及總體醫療利用情形也會較低。因此建議衛生主管機關可考量將牙醫師納入糖尿病照護團隊的一環，並建立相關轉介管道與機制。 | zh_TW |
| dc.description.abstract | Background: Hemoglobin A1c(HbA1c) is associated with severe periodontal ailment among patients with type 2 diabetes, and can be lowered by non-surgical periodontal treatment. However, data from empirical studies on diabetes and periodontal treatment interventions are not robust, as Taiwan lacks population-based data.
Objective: To evaluate the effect of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes. Methods: The retrospective cohort study was designed using the database of National Health Insurance for secondary analysis. Patients diagnosed with type 2 diabetes and periodontal disease in 2017 were selected, and we have used propensity score matching to reduce bias between treatment and control groups on a large number of covariates. If the difference between the results of 2017 and 2018 diabetes outcomes and utilization is due to periodontal treatment intervention is to be ascertained. Results: After dental scaling or subgingival curettage, compared with those who did not receive the treatment, the ratio of odds of subsequent HbA1c below 7% was 1.065, and the risk of renal ailment was lower by 13%, and of hospitalization by 27%. The data analysis shows that there was an increase in the number of medical outpatient visits, of dental visits, and total dental expenses, but there was decrease in the average length of hospital stays, total hospitalization expenses, and overall medical expenses. Conclusions: Patients with type 2 diabetes and periodontal disease who have received periodontal treatment have better subsequent diabetes outcomes, and lower hospitalization need and overall medical care. Hence, we recommend that health policymakers consider the inclusion of dentists in Diabetes Shared Care team and institute relevant referral systems. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-17T07:02:43Z (GMT). No. of bitstreams: 1 ntu-108-R06848025-1.pdf: 2194417 bytes, checksum: edcd511be95c45a266fad93a2913d844 (MD5) Previous issue date: 2019 | en |
| dc.description.tableofcontents | 口試委員會審定書 i
致謝 ii 中文摘要 iii Abstract iv 第一章 緒論 1 第一節 研究背景與動機 1 第二節 研究目的 3 第三節 研究重要性 4 第二章 文獻探討 5 第一節 糖尿病之綜論 5 第二節 牙周病之介紹 8 第三節 糖尿病與牙周病之關係 13 第四節 糖尿病控制結果之影響因素 15 第五節 牙周病與糖尿病之相關實證研究 17 第三章 研究設計與方法 28 第一節 研究設計與架構 28 第二節 研究假說 30 第三節 研究對象 31 第四節 資料來源與處理流程 32 第五節 研究變項及操作型定義 35 第六節 統計分析方法 39 第四章 研究結果 41 第一節 描述性統計 41 第二節 雙變項分析 47 第三節 多變項分析 59 第五章 討論 95 第一節 研究方法討論 95 第二節 研究結果討論 97 第三節 研究限制 104 第六章 結論與建議 105 第一節 結論 105 第二節 建議 106 參考文獻 107 附錄 114 | |
| dc.language.iso | zh-TW | |
| dc.subject | 第二型糖尿病 | zh_TW |
| dc.subject | 牙周病 | zh_TW |
| dc.subject | 牙結石清除 | zh_TW |
| dc.subject | 齒齦下刮除術 | zh_TW |
| dc.subject | 糖化血色素 | zh_TW |
| dc.subject | type 2 diabetes | en |
| dc.subject | periodontal disease | en |
| dc.subject | dental scaling | en |
| dc.subject | subgingival curettage | en |
| dc.subject | glycated hemoglobin A1c | en |
| dc.title | 探討牙結石清除及齒齦下刮除術對糖尿病病人照護結果及利用之影響 | zh_TW |
| dc.title | The impact of dental scaling and subgingival curettage on outcomes and healthcare utilization among patients with diabetes | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 107-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.oralexamcommittee | 鄭守夏(Shou-Hsia Cheng),杜裕康(Yu-Kang Tu) | |
| dc.subject.keyword | 第二型糖尿病,牙周病,牙結石清除,齒齦下刮除術,糖化血色素, | zh_TW |
| dc.subject.keyword | type 2 diabetes,periodontal disease,dental scaling,subgingival curettage,glycated hemoglobin A1c, | en |
| dc.relation.page | 116 | |
| dc.identifier.doi | 10.6342/NTU201902260 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2019-07-31 | |
| dc.contributor.author-college | 公共衛生學院 | zh_TW |
| dc.contributor.author-dept | 健康政策與管理研究所 | zh_TW |
| 顯示於系所單位： | 健康政策與管理研究所 | |
文件中的檔案：
| 檔案 | 大小 | 格式 | |
|---|---|---|---|
| ntu-108-1.pdf 未授權公開取用 | 2.14 MB | Adobe PDF |
系統中的文件，除了特別指名其著作權條款之外，均受到著作權保護，並且保留所有的權利。