高的血糖达标值知晓率可以提高糖化血红蛋白达标率

Knowledge of blood sugar control standard brings the higher attainment rate of HbA1c

目的:探讨和分析影响血糖的可控因素。方法:采用横断面研究方式,选择已确诊3个月以上的糖尿病患者430人,通过调查问卷的形式收集其人口统计学资料、临床及其他可能与血糖控制相关的资料,同时收集其血液标本测定糖化血红蛋白值(HbA1c)。采用多元线性回归分析与单因素回归分析方法进行统计分析,分析各因素对HbA1c控制达标的影响。结果:430例糖尿病患者HbA1c为(8.7±2.6)%,34%的糖尿病患者HbA1c≤7.0%。单因素回归分析发现年龄越大、参加糖尿病教育、更高频率的血糖监测、对血糖控制目标的知晓、更好的公共卫生环境、拥有血糖仪的患者HbA1c控制较好,但是升级的治疗方法,如胰岛素治疗的患者HbA1c控制较差。多元线性回归分析发现年龄越大、参加糖尿病教育、更高频率的血糖监测、对血糖控制目标的知晓是HbA1c的保护因素,升级的治疗方法是HbA1c的危险因素。结论:对血糖控制目标的知晓、参加糖尿病教育、更高频率的血糖监测是有利于HbA1c达标的可控因素,且提高血糖控制目标的知晓率可能是降低患者HbA1c最简单有效的方法。

Objective： To analyze the important controllable factors which affect the glycemic control of diabetes. Methods： A cross-sectional study was carried out to examine the role of relevant characteristics in glycemic control by a sampling investigation of 430 diabetic patients in Hunan, China. A questionnaire was designed for personal interviews to collect data. Univariate regression analysis and multiple linear regression analysis were used to evaluate the effects of various factors on glycated hemoglobin A1 c （HbAlc） control. Results： The level of HbAlc in 430 patients was （8.7＋2.6）%, and the value in 34% patients among them was ≤ 7.0%. Base on univariate regression analysis some factors were associated with good HbAlc control, including age, diabetic education, self monitoring of blood glucose, knowledge of blood sugar control standard, living environment, and self-owned glucometer. However, the upgraded treatment was associated with poor control. Based on multiple linear regression analysis, the first four factors mentioned above were protective factors for HbAlc while upgraded treatment was risk factor for HbAlc. Conclusion： Knowledge of blood sugar control standard, diabetic education and self monitoring of blood glucose are important controllable factors for better glycemic control of diabetes.