中国2型糖尿病患者人胰岛素治疗状况调查的研究

Glycemic and HbA_1c controls of T2DM patients treated with human insulin in China

目的了解我国城市地区医院门诊T2DM患者人胰岛素使用情况、HbA_1 c达标率及相关影响因素。方法在全国范围内314家三级甲等医院内分泌专科门诊选取符合纳入和排除标准,且采用人胰岛素单用或联用口服降糖药治疗方案的T2DM患者,获取相关信息。结果共纳入T2DM患者80407例,其中男44031例,女36376例,平均病程(6.74±4.31)年。起始人胰岛素治疗时平均病程为(3.75±3.33)年。因口服降糖药物疗效不佳而改用起始人胰岛素治疗者84.6%。平均人胰岛素用量为(31.6±9.43)U/d,餐时胰岛素+基础胰岛素、餐时胰岛素、基础胰岛素和预混人胰岛素的构成比分别为3.06%、3.78%、3.40%和89.8%。调查对象的HbA_1c达标率(<7.0%)为27.0%,FPG达标率(<7.2mmol/L)为42.9%,2 hPG达标率(≤10.0 mmol/L)为49.8%。结论中国T2DM患者应用人胰岛素治疗中预混人胰岛素的构成比最高,不同治疗方案者的HbA_1c、空腹和餐后血糖达标率均不高。

Objective To assess the glycemic and HbA1 c controls of T2DM patients receiving treatment of human insulin regimen in China. Methods From March to June in 2012,T2DM outpatients on the therapy of human insulin, meeting the inclusion criteria, with complete patient medical records, were selected from 314 hospitals across China and filled out the information form. Results Valid data were obtained from 80407 patients, including 44031 males and 36276 females. Patients aged （59.3 ± 10.3） years. The average duration of diabetes was（6.74± 4.31）years. The average diabetic course before starting the initial human insulin was（3.75±3.33）years. The 84. 6% of patients started insulin therapy due to the poor effect of oral hypoglycemic agents. The average dosage of human insulin was（31.6±9.43） U/d. Among patients treated with human insulin, the proportions of patients receiving meal-time insuling plus NPH, meal-time insulin, premixed, and NPH were 3.06%, 3.78%, 89.8% and 3.4% respectively. The percentage of patients achieving the targets of HbAlc （〈7. 0%）, FPG （〈7.2 mmol/L）, 2 hPG （410 mmol/L） was 27.0% ,42.9% ,49.8% respectively. Conclusion The glycemic and HbAlc controls are poor in human insulin treated T2DM patients in China. The prop6rtions of patients receiving premixed human insulin are highest.