老年糖尿病患者血糖高质量达标的影响因素分析  

Factors influencing good blood glucose control in elderly diabetic patients

作　　者：乔修琪 安娜 王明辉 王红 赵付英 栾然 曹嘉明 潘琦[1,2] Qiao Xiuqi;An Na;Wang Minghui;Wang Hong;Zhao Fuying;Luan Ran;Cao Jiaming;Pan Qi(Department of Endocrinology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Peking Union Medical College and Chinese Academy of Medical Sciences,Beijing 100730,China;Beijing Jingmei Group General Hospital,Beijing 102300,China;Puhuangyu Community Health Service Center,Fengtai District,Beijing 100075,China;Tiantan Community Health Service Center,Dongcheng District,Beijing 100050,China;Gaobeidian Community Health Service Center,Chaoyang District,Beijing 100024,China;MaJiaPu Community Health Service Center,Fengtai District,Beijing100067,China)

机构地区：[1]北京医院内分泌科国家老年医学中心中国医学科学院老年医学研究院,北京100730 [2]北京协和医学院中国医学科学院,北京100730 [3]北京京煤集团总医院,北京102300 [4]北京市丰台区蒲黄榆社区卫生服务中心,北京100075 [5]北京市东城区天坛社区卫生服务中心,北京100050 [6]北京市朝阳区高碑店社区卫生服务中心,北京100024 [7]北京市丰台区马家堡社区卫生服务中心,北京100067

出　　处：《中华老年医学杂志》2024年第8期994-999,共6页Chinese Journal of Geriatrics

基　　金：医科院创新工程:中国医学科学院创新工程(2021-I2M-1-050)。

摘　　要：目的调查老年糖尿病患者的病情管理情况,探讨影响高质量达标的相关因素。方法采用问卷调查的方法,回顾性收集北京市5个社区卫生服务中心2022年6月就诊的老年糖尿病患者的血糖控制相关信息,根据是否符合糖化血红蛋白(HbA_(1c))<7%且无低血糖、无体重增加的标准分为高质量达标组和非高质量达标组,应用单因素及多元逐步Logistic回归,分析影响老年糖尿病患者高质量达标的危险因素。丝结果共回收有效问卷287份,高质量达标组80例(27.9%),非高质量达标组207例(72.1%)。两组中性别、病程、有无低血糖、慢性并发症数量、用药剂型、饮酒≥100g/d、饮食变化、忘服药次数≥1次/周、门诊间隔延长、情绪低落的差异有统计学意义(均P<0.05)。多元逐步Logistic回归分析显示,使用胰岛素、忘服药次数≥1次/周、门诊间隔延长是影响高质量控制的独立危险因素(均P<0.05)。结论老年糖尿病患者的高质量达标率较低,影响老年糖尿病患者高质量达标的因素有胰岛素的使用、用药依从性、门诊间隔延长。Objective To investigate blood glucose management in elderly diabetic patients and the factors that affected achieving high rates of achieving it.Methods The quality of blood glucose control by elderly diabetic patients who visited five community health service centers in Beijing in June 2022 was surveyed retrospectively using a questionnaire.Participants were divided into the high-quality group and not high-quality groups by the criteria of glycosylated hemoglobin(HbA_(1c))<7%without hypoglycemia and weight gain.Single factor analysis and multiple-stepwise Logistic regression analysis were used to identify the relative risk of factors affecting the achievement of good glucose management.Results A total of 287 valid questionnaires were collected,including 80 cases(27.9%)in the high-quality group and 207 cases(72.1%)in the not high-quality group.There were significant differences in sex,course of disease,occurrence of hypoglycemia,number of chronic complications,medication,alcohol consumption,dietary changes,missed medication doses,prolonged outpatient visit intervals,and depressive mood between the two groups(P<0.05).Multivariate stepwise logistic regression analysis showed that insulin use,missed medication≥1 time/week,and prolonged outpatient visit intervals were independent risk factors for good control(P<0.05).Conclusions The percentage of elderly diabetes patients with good blood glucose control was low.Factors affecting the rate included insulin use,medication compliance,and prolonged outpatient visit intervals.

关 键 词：糖尿病 疾疾病管理 血糖 

分 类 号：R587.1[医药卫生—内分泌]