中国2型糖尿病药物治疗现状与血糖控制的调查研究

Status of blood glucose control and treatment of type 2 diabetes in China

目的了解现阶段中国2型糖尿病（T2DM）患者血糖控制及治疗情况。方法2009、2010年连续2年在全国范围内选择各省／市具有代表性的重点医院门诊就诊的单纯口服药或口服药联合胰岛素治疗的T2DM患者，按照《数据采集标准操作流程（SOP）》询问患者，收集了解患者治疗、血糖控制和慢性并发症情况，并填写至《监测网登记表》。以糖化血红蛋白（HbAlC）〈6．5％为达标。所有数据采用描述性统计分析。结果2009年共入组143123例患者，平均年龄（59±12）岁，63．8％（91312例）至少有一种伴随疾病；2010年共人组172199例患者，平均年龄（59±11）岁，54．7％（94193例）至少有一种伴随疾病。2009和2010年平均HbAlC水平分别为8．0％±2．0％和7．9％±1．8％，达标率分别为20．3％和16．8％，分别有高达79．7％和83．2％的患者HbAlC不达标。在2009年仅使用口服药治疗的患者中，平均HbAlC水平为7．7％±1．9％，达标率为23．4％，76．6％的患者HbAlC不达标。2009和2010年，采用单纯口服药治疗方案的调查患者，无论使用何种治疗方案，HbAlc、空腹血糖和餐后2h血糖的平均值均不达标。结论我国T2DM的HbAlc达标率低，应大力普及和推广糖尿病指南，强化综合治疗达标。

Objective To assess the status of glycemic control and treatment of type 2 diabetes mellitus （T2DM） in China. Methods This was a cross-sectional study carried out all over the China. A total of 400 and 435 hospitals were involved in 2009 and 2010 investigation respectively. Type 2 diabetic outpatients on oral antidiabetic drugs （OADs） only or OADs combined with insulin treatment were included. Data on general characteristics, treatment regimen, complications and blood glucose levels were collected using a questionnaire interview. A glycated hemoglobin Alc （HbAlc） of less than 6. 5% was set as treatment target. Data were analyzed using descriptive statistics. Results In 2009 and 2010, 143 123 （ aged （ 59 ± 12 ） years ） and 172 199 patients （ aged （ 59 ± 11 ） years ） were enrolled, with 63.8% and 54.7% of the patients with at least one concomitant disease respectively. In 2009, the overall glycated hemoglobin Alc（HbAlc） level was 8.0% ± 2. 0%, and 79. 7% of the patients failed to reach the target of HbAlc（ 〈6. 5% ）. Patients treated with OADs only had a HbAlc of 7.7% ±1.9%, and 76. 6% of them failed to reach the target. Overall HbAlc level in 2010 was 7.9% ± 1.8% , 83.2% of the patients failed to reach the target of HbAlc（ 〈6. 5% ）. Among all patients treated with OADs-only in both years, the mean values of HbAlc, fasting blood glucose and postprandial glucose did not reach the target under all treatment regimens. Conclusions The overall glycemic control in Chinese type 2 diabetic patients is poor. More complex diabetic management are needed to improve blood glucose management.