北京市社区2型糖尿病患者糖化血红蛋白水平控制现状及其影响因素——北京社区糖尿病研究BCDS-3

Current HbA_1c status and its influencing factors of type 2 diabetes in Beijing communities:Beijing Community Diabetes Study-3

目的了解北京社区2型糖尿病患者HbA_1c水平控制现状,分析相关影响因素。方法采用多级抽样方法,纳入北京市5个城区中15个社区卫生服务中心2477例2型糖尿病患者。全体参与专门培训后,按操作规范对患者进行体格检查及相关实验室检查,填写调查表。结果 (1)HbA_1c<6.5%者788例,占31.8%;HbA_1c≥6.5%者1689例,占68.2%。(2)不同HbA_1c水平组,其年龄、糖尿病病程、体质指数、腰围、血压、空腹血糖、甘油三脂、总胆固醇、低密度脂蛋白胆固醇、经济水平、文化程度间差异均有统计学意义。(3)经调整相关因素影响后,文化程度对HbA_1c水平有独立影响。结论北京市社区2型糖尿病患者血糖控制达标现状不容乐观。血糖控制受到多种因素影响,其中文化程度低是独立危险因素。提示糖尿病社区管理应该更加注重个体化,对较低文化水平的患者人群应给予更多关怀。

Objective To investigate current HbA1 c status of type 2 diabetes in Beijing communities and to analyze its related risk factors. Methods Using multi-stage sampling, 2477 type 2 diabetic patients from 15 Beijing urban communities were studied. The biochemical and physical examination were completed by general practitioners with special skill training. Results （1）The patients with HbAx c less than 6.5 were 788 （31. 8%） cases, HbA1c more than or equal to 6.5% were 1689 （68.2%） cases. （2） There were significantly differences in age, duration of diabetes, body mass index （BMI）, waist circumference, blood pressure, fasting blood glucose, triglyceride, total cholesterol, low-density lipoprotein cholesterol, economic status and educational degree among patients with different HbA1c level. （3） After adjustment for age, duration of diabetes, obesity and high cholesterol, the inadequte educational degree was an independent risk factor for the HbAlc level. Conclusions Current status of blood glucose control in patients with type 2 diabetes in Beijing communities is not optimistic. The inadequate educational degree is an independent risk factor. More efforts should be taken to the community-based individual management for diabetic patients, particularly for the low-literacy group.