无锡市城乡社区2型糖尿病患者血糖控制现状及影响因素分析

Status and its Influencing Factors of Blood Glucose Control in Managed Diabetes in Urban and Rural Community of Wuxi City

目的了解无锡市城乡社区2型糖尿病患者血糖控制现状及影响血糖控制的因素。方法于2010年,采取两阶段整群抽样的方法,分别在无锡市城市和农村中各抽取2个社区,对登记管理的940例2型糖尿病患者(城区560例,农村380例)开展问卷调查、体格检查和血生化检查。依据亚洲-太平洋地区2型糖尿病政策组制订的糖尿病控制目标进行控制状况的评估;以血糖控制目标(空腹血糖≤7.0mmol/L)作为应变量,进行单因素、多因素非条件Logistic回归,分析影响血糖控制的因素。结果无锡市城市社区管理的2型糖尿病患者中血糖、血压、体质指数、总胆固醇、三酰甘油、高密度脂蛋白胆固醇控制达到理想状态的分别占25.4%、38.8%、46.4%、20.5%、40.7%和81.6%,而农村患者分别为8.2%、26.6%、41.3%、13.7%、42.4%和85.8%,城市社区2型糖尿病患者血糖、血压、总胆固醇指标控制状况显著好于农村(P<0.05)。多因素非条件Logistic回归分析显示,影响患者血糖控制的不利因素有家庭收入低、糖尿病病史长、有糖尿病家族史、体育锻炼少、血压水平高等。结论无锡市城乡社区2型糖尿病患者血糖、血压控制状况不容乐观,农村尤为严重,社区糖尿病患者管理工作需进一步加强。

Objective To understand the control status of type 2 diabetes that had been managed by the community health service center and explore the influencing factors of glucose control. Methods The stratified cluster random sampling method was conducted to select 2 communities from urban and rural, respectively, in Wuxi municipal area. Total 940 patients with type 2 diabetes （560 cases from urban, 380 cases from rural） managed by community health service center were selected and investigated with questionnaire, while taken physical and biochemical examination. The control target of diabetes formulated by type 2 diabetes policy group in Asia - Pacific region was used to evaluate the control status. Logistic regression was used to analyze the factors which could influence the glucose control of diabetes. Results The ideal control rates of fasting blood glucose （FBG）, blood pressure （BP）, body mass index （BMI）, total cholesterol （TC）, triglyceride （TG） and high density lipoprotein （HDL） were 25.4%, 38.8%, 46.4%, 20.5%, 40.7% and 81.6% respectively in urban cases, whereas they were 8.2%, 26.6%, 41.3%,13.7%,d2.4% and 85.8% respectively in rural cases. The ideal control rates of FBG, BP and TC were significantly higher in urban than those in rural. Multi-variables Logistic regression showed that low per-capita family income, long course of diabetes, family history of diabetes, lack of exercise, and high blood pressure were the major disadvantageous factors for glucose control. Conclusion The management of diabetes in community health service center should be improved, especially in rural areas.