上海市浦江社区短病程2型糖尿病患者血糖控制影响因素分析  

Impact factors of glycemic control in patients with short-term history type 2 diabetes mellitus in Pujiang community in Shanghai

作　　者：李志勇 刘宇[2] 黄薇 凌小媛 麻静[3] 

机构地区：[1]上海市闵行区浦江社区卫生服务中心,上海201112 [2]上海交通大学医学院附属仁济医院南院内分泌科,上海201112 [3]上海交通大学医学院附属仁济医院内分泌科,上海200127

出　　处：《上海交通大学学报（医学版）》2018年第1期89-94,共6页Journal of Shanghai Jiao tong University:Medical Science

基　　金：国家自然科学基金(81670728;71373160);上海市卫生和计划生育委员会科研基金(201740054)~~

摘　　要：目的·分析上海市闵行区浦江社区短病程2型糖尿病患者血糖控制的现状及影响因素。方法·选取社区1 994例2型糖尿病患者,完成问卷调查,检测空腹血糖(FPG)、糖化血红蛋白(Hb A1c)和标准100 g馒头餐后2 h血糖(PPG)。429例病程在5年内的患者纳入分析。血糖达标定义为FPG<7.0 mmol/L且PPG<10.0 mmol/L,且Hb A1c<7.0%。结果·血糖达标率为7.9%,FPG达标率为32.6%,PPG达标率为12.6%,Hb A1c达标率为38.2%。接受中高等教育是血糖达标的保护因素(校正后,OR=0.60,95%CI0.37~0.96)。长病程、胰岛素抵抗严重和血压未达标是血糖达标的危险因素(校正后数值分别为:OR=1.95,95%CI 1.30~2.91;OR=2.52,95%CI 1.57~4.03;OR=1.94,95%CI 1.22~3.09)。结论·上海市浦江社区短病程2型糖尿病患者血糖达标率低,需要对受教育程度低的患者加强餐后血糖控制宣教。Objective To access glycemic control status and investigate its impact factors of patients with short-term history of type 2 diabetes mellitus in Pujiang Town, Minhang District, Shanghai. Methods The clinical information was collected by a standard questionnaire in 1 994 type 2 diabetic mellitus patients from the community. FPG, HbA 1 c, and PPG after meal of 100 g steamed bread made of standard flour were measured. 429 patients with 5-years duration of diabetes were qualified in the final analysis. Ideal blood glucose control was FPG〈7.0 retool/L, PPG〈10.0 mmol/L and HbAlc〈7.0%. Results. The proportion of patients with ideal blood glucose, FPG, PPG, and HbAlc control were 7.9%, 32.6%, 12.6% and 38.2%, respectively. Patients with middle school- and high school-education were at lower risks for poor glycemic control （age- and sex- adjusted OR 0.60, 95% CI 0.37-0.96）. Duration of diabetes, insulin resistance and blood pressure were negatively associated with glycemic control （age- and sex- adjusted, OR=1.95, 95% CI 1.30-2.91; OR=2.52, 95% CI 1.57-4.03 ;OR=1.94, 95% CI 1.22-3.09, respectively）. Conclusion Patients in Pujiang community had substantially poor glycemic control. Less-educated diabetic patients should be emphasized on the importance of postprandial glycemic control.

关 键 词：社区 2型糖尿病 血糖控制 影响因素 

分 类 号：R587.101[医药卫生—内分泌]