2型糖尿病患者血糖未达标的现状分析

Analysis of Type 2 Diabetic Patients with Glycemic Nonattainment

目的探讨北京市和平里地区2型糖尿病血糖未达标患者的现状,为制订应对策略提供理论依据。方法采用统一的调查问卷方法调查86例2型糖尿病血糖未达标患者的年龄、生活方式干预、药物治疗、患者依从性及有无并发症等情况,比较分析不同年龄阶段患者的血糖控制情况以及不同用药情况对患者血糖控制的影响。结果在统计的未达标患者中,糖化血红蛋白(HbA1c)均值为7.9%,空腹血糖均值为8.3 mmol/L,餐后血糖均值为11.4 mmol/L。不同年龄组患者间的血糖控制水平差异无统计学意义(P>0.05);生活方式干预方面,仅39例患者能按医嘱严格控制饮食,30例患者基本不进行体育锻炼;分别有20.93%和31.40%的患者不进行空腹和餐后血糖的监测;联合用药组空腹血糖较单药组低(P<0.05),两组餐后血糖和HbA1c比较差异无统计学意义(P>0.05)。结论对于未达标患者,需要进一步强化患者教育,加强生活方式干预,选择更加强化,同时安全、依从性好的降糖治疗方案。

Objective To investigate the current status of type 2 diabetic patients who failed to achieve the glycemic control target in Hepingli area of Beijing,and provide theoretic evidences for making corresponding strategies.Methods 86 cases of type 2 diabetes who failed to reach the glycemic target were recruited from Hepingli area of Beijing and given a standard questionnaire,including the information of conditions of their age,lifestyle intervention,drug treatment,compliance and complications.Glycemic control of different age groups and influence of different medications on the glycemic control were analyzed and compared.Results Among these patients,the mean HbA1c was 7.9%,the mean fasting plasma glucose was 8.3 mmol/L,and the mean postprandial plasma glucose was 11.4 mmol/L.Glycemic control between patients of different age groups were not significantly different（P0.05）;as for lifestyle intervention,only 39 cases of patients took their diet control strictly as prescribed and 30 cases of patients have little exercise;20.93% and 31.40% of patients did not monitor their fasting and postprandial plasma glucose,respectively.The blood-fasting sugar in combination therapy was lower than in mono-therapy（P0.05）,there were no significant differences in posprandial plasma glucose and HbA1c between combination therapy and mono-therapy（P0.05）.Conclusion It is necessary to further enhance patients′ education,to improve life style intervention,as well as to select more effective,safer,and compliant hypoglycemic treatments to patients of nonattainment.