广东省1型糖尿病患者血糖控制现状及相关因素的横断面调查

Cross-sectional study of current situation of glycemic control with type 1 diabetes in Guangdong Province

目的 了解广东省1型糖尿病（T1DM）患者血糖控制现状和相关因素.方法 在广东省21个地级市的89家三级和二级医院收集T1DM患者的血标本和临床资料.通过分析临床资料,了解影响血糖控制的因素.以糖化血红蛋白（HbA1c）评价血糖控制水平,HbA1c统一在广东省糖尿病防治中心检测.结果 2010年8月6日至2011年5月25日共调查纳入广东省851例T1DM患者.其中男408例,女443例.患者年龄的中位数为29.6岁（20.3 ～41.3岁）；发病年龄为25.3岁（15.7 ～35.5岁）；病程为3.3年（1.0～7.3年）；体质指数（BMI）为19.9 kg/m2（17.9 ～21.8 kg/m2）.HbA1c为8.6％（6.9％ ～11.0％）,234例（27.50％）患者达到相应年龄患者的血糖控制目标.13 ～ 19岁患者、家庭年收入低、未控制饮食和未接受糖尿病教育、病程短的患者血糖控制差.结论 广东省大多数T1DM患者血糖控制未达标,迫切需要采取措施改善这一现况.

Objective To investigate the glycemic control and the related factors of type 1 diabetic patients in Guangdong Province.Methods Medical records and blood samples of type 1 diabetic patients were collected in 89 tertiary and secondary hospitals from all of the 21 cities in Guangdong Province.The clinical data were analyzed to explore the correlates of glycemic control.HbA1 c levels,measured in Guangdong Diabetes Center,were used to assess glycemic control.Results 851 patients were enrolled from August 6,2010 to May 25,2011.There were 408 males and 443 females.The median（interquartile range）age was 29.6 years（20.3-41.3 years）.The onset age of diabetes was 25.3 years（15.7-35.5years）.The disease duration was 3.3 years（1.0-7.3 years）.The BMI was 19.9 kg/m2（17.9-21.8 kg/m2）.HbA1 c levels were 8.6%（6.9%-11.0%）and only 234（27.50%）patients reached the agespecific target levels.Correlates with poorer glycemic control were 13-19 years old（vs 7-12 and ≥20years old）,lower household income,not on dietary intervention,never accepting diabetic education and shorter diabetic duration.Conclusion The majority of Guangdong type 1 diabetic patients did not achieve target values for glycemic control,indicating an urgent need for comprehensive management to improve glycemic control.