年龄及其行为因素与糖尿病患者饮食控制及其相关危险因素的关系:4 265例分析

Crrelation of age and its behavial factors with diet control and its related risk factors in diabetes patients:analysis in 4 265 patients

目的:通过对糖尿病患者饮食治疗情况调查,分析不同依从性患者临床特点及疾病与代谢控制情况,为进一步搞好糖尿病饮食治疗提供依据。方法:对1994-06/2003-07在解放军第三○六医院糖尿病中心首次进行糖尿病并发症筛查的4265例糖尿病患者进行饮食治疗情况调查。按照尚未控制饮食(未控制组)、饮食控制好(优组)、饮食有时控制不好(良组)、饮食经常控制不好(中组)、不控制饮食(差组)进行分组。比较各组间临床特点(年龄、病程、吸烟及饮酒情况、受教育与职业状况、体质量指数、腰围、)、代谢控制(糖代谢、脂代谢、胰岛功能等)情况、糖尿病并发症患病等疾病状况之间的差异。对饮食控制情况与临床特点、代谢控制指标及并发症之间的关系进行分析。结果:未控制组717例(16.8%),优组1006例(23.6%),良组1402例(32.9%),中组801例(18.8%),差组339例(8.0%)。除未控制组外,其余各组间病程、空腹胰岛素及餐后胰岛素间差异均无显著性意义(P>0.05)。饮食控制顺从性差的患者腰围、体质量指数、空腹及餐后血糖、糖化血红蛋白、胆固醇、三酰甘油、尿微量白蛋白、眼底病变及酮症酸中毒均显著高于饮食控制好的患者(t=1.961～>3.291,P<0.05～0.01),而年龄及受教育程度高的患者饮食控制相对较好。结论:饮食控制好的患者血糖、血脂、?

AIM:To analyze the clinical features and the control status of disease and metabolism in patients with different compliance through the investigation on diet treatment,and provide supports for diabetes diet treatment.METHODS:Diet treatment was investigated in 4 265 diabetic patients with diabetic complication who were firstly screened in the 306 Hospital of Chinese PLA from June 1994 to July 2003.They were divided into 5 groups according to the diet control levels:The patients not treated with diet control were in the uncontrolled group(UCG),those treated with diet control well were in the very good group(VGG),those treated with worse diet control occasionally were in the good group(GG),those treated with worse diet control usually were in the fair group(FG),and those untreated with diet control were in the bad group(BG).Differences of clinical features[age,course,smoking and drinking status,education and professional status,body mass index(BMI),waistline],metabolic control(glycometabolism,lipid metabolism,pancreatic islets function,etc.)and diabetic compliance were compared,and their correlations were analyzed.RESULTS:There were 717 patients in the UCG(16.8%),1 006 in the VGG(23.6%),1 402 in GG (32.9%),801 in FG(18.8%),and 339 in the BG(8.0%).Differences of course,fasting insulin and insulin after meals had no significant meaning in the groups except the UCG(P >0.05).Waistline,fasting insulin and insulin after meals,sugar ferrohemoglobin,cholesteryl,triglyceride(TG) urine microalbumin,lesion in fundus oculi and keton acidosis in patients with worse diet control compliance were significantly higher than those in the patients with better one(t=1.961 to >3.291,P< 0.05 to 0.01),while diet control in patients with higher education was relatively better.CONCLUSION:Blood sugar,lipid,waistline,BMI in patients with better diet control are significantly improved.Compliances and united symptoms of diabetes are decreased.Young patients with lower education have more serious diet control problem.