社区2型糖尿病患者血糖控制达标的影响因素分析  

Factors affecting the achievement of the target for blood glucose control among community patients with type 2 diabetes mellitus

作　　者：王慧 高霞[1] 朱晓云[1] 马芳军 WANG Hui;GAO Xia;ZHU Xiaoyun;MA Fangjun(Department of Quality Management,Jinshan District Center for Disease Control and Prevention,Shanghai 201599,China)

机构地区：[1]上海市金山区疾病预防控制中心质量管理科,上海201599

出　　处：《预防医学》2024年第5期423-427,共5页CHINA PREVENTIVE MEDICINE JOURNAL

基　　金：上海市金山区卫生健康委员科研课题项目(JSKJKTGW)。

摘　　要：目的了解社区2型糖尿病(T2DM)患者血糖控制达标情况及影响因素,为制定血糖管理策略和干预措施提供依据。方法通过上海市金山区慢性病随访管理系统和区级信息平台收集社区持续随访管理、年龄≥18岁且在金山区居住时间>6个月的T2DM患者的基本信息、生活方式、服药情况、疾病情况和糖化血红蛋白(HbA1c)等资料,以HbA1c<7%为血糖控制达标,分析血糖控制达标率;采用多因素logistic回归模型分析血糖控制达标的影响因素。结果纳入T2DM患者16758例,其中男性7844例,占46.81%;女性8914例,占53.19%。年龄M(QR)为69.00(12.00)岁。血糖控制达标8095例,达标率为48.31%。多因素logistic回归分析结果显示,年龄(60~<70岁,OR=0.749,95%CI:0.675~0.832;70~<80岁,OR=0.892,95%CI:0.801~0.993;≥80岁,OR=1.238,95%CI:1.086~1.411)、体质指数(超重,OR=0.926,95%CI:0.863~0.993;肥胖,OR=0.800,95%CI:0.718~0.891)、病程(6~<11年,OR=0.728,95%CI:0.673~0.787;≥11年,OR=0.534,95%CI:0.489~0.583)、吸烟(每天,OR=0.792,95%CI:0.730~0.860)、饮酒(每天,OR=0.788,95%CI:0.642~0.967)、服药依从性(间断,OR=0.293,95%CI:0.271~0.317;自行停药,OR=0.074,95%CI:0.064~0.087)、合并高血压(OR=0.643,95%CI:0.588~0.703)、合并心脑血管疾病(OR=0.671,95%CI:0.563~0.800)是T2DM患者血糖控制达标的影响因素。结论T2DM患者血糖控制主要受年龄、体质指数、病程、吸烟、饮酒、服药依从性和合并症的影响。Objective To investigate the achievement of the target for blood glucose control among community patients with type 2 diabetes mellitus(T2DM)and its influencing factors,so as to provide insights into developing blood glucose management strategies and intervention measures.Methods Basic information,lifestyle,medication use,disease history,and HbA1c test results of T2DM patients aged 18 years and older and living in Jinshan District,Shanghai Municipality for more than 6 months were collected through Jinshan District Chronic Disease Follow up Management System and dis⁃trict-level information platform.The proportion of blood glucose achieving the control target(HbA1c<7%)was analyzed.Factors affecting the achievement of the target for blood glucose control were identified using a multivariable logistic re⁃gression model.Results A total of 16758 T2DM patients were included,with 7844 males(46.81%)and 8914 fe⁃males(53.19%),and a median age of 69.00(interquartile range,12.00)years.There were 8095 patients achieving the blood glucose control target,accounting for 48.31%.Multivariable logistic regression analysis showed that age(60-69 years,OR=0.749,95%CI:0.675-0.832;70-79 years,OR=0.892,95%CI:0.801-0.993;≥80 years,OR=1.238,95%CI:1.086-1.411),body mass index(overweight,OR=0.926,95%CI:0.863-0.993;obesity,OR=0.800,95%CI:0.718-0.891),disease course(6-10 years,OR=0.728,95%CI:0.673-0.787;≥11 years,OR=0.534,95%CI:489-0.583),smoking(daily,OR=0.792,95%CI:0.730-0.860),drinking(daily,OR=0.788,95%CI:0.642-0.967),medication adherence(intermittent,OR=0.293,95%CI:0.271-0.317;self discontinuation,OR=0.074,95%CI:0.064-0.087),hypertension(OR=0.643,95%CI:0.588-0.703)and cardiovascular and cerebrovascular diseases(OR=0.671,95%CI:0.563-0.800)were the influencing fac⁃tors for the achievement of the target for blood glucose control among T2DM patients.Conclusion The blood glucose control among T2DM patients is mainly affected by age,body mass index,disease course,smoking,drinking,medication adherence and comorbidities.

关 键 词：2型糖尿病 血糖控制 影响因素 

分 类 号：R587.1[医药卫生—内分泌]