Ⅱ型糖尿病患者饮食、运动疗法与糖化血红蛋白控制现状及相关因素分析

Situation analysis on diet,exercise,HbA_1C and its related factors in typeⅡ diabetic patients

目的了解Ⅱ型糖尿病(T2DM)患者饮食控制、运动疗法和糖化血红蛋白(HbA1C)控制现状及相关影响因素。方法随机抽取T2DM患者61例,对患者进行个人基本资料、糖尿病饮食治疗、运动治疗状况调查,分析影响HbA1C控制的相关因素。结果糖尿病饮食治疗、运动治疗依从率分别为68.8%和68.85%,HbA1C达标率36.07%。年龄<50岁HbA1C均值低于>50岁患者,且有统计学差异[(7.3±1.54)%vs(8.5±2.06)%,P=0.01]。小学及以下文化程度患者(9.20±2.06)%HbA1C均值明显高于初中(7.35±1.52)%、高中(7.45±1.79)%、大专及以上(8.22±2.01)%文化程度患者,差异有统计学意义(P=0.049)。HbA1C与文化程度、吸烟史、糖尿病病程、体重指数(BMI)、饮食控制情况及平均每日运动时间之间无明显相关性(P>0.05)。结论T2DM患者饮食和运动治疗的依从率及HbA1C达标率较之前有提高,但仍未达到满意水平。加强无糖尿病家族史、低文化程度及老年糖尿病患者的糖尿病知识健康教育对血糖的控制有重要的临床意义。

Objective To investigate the status of diet,exercise,HbA1 C in type 2diabetic（T2DM）patients and analyze the related factors of HbA1 C.Methods 61 patients were enrolled.All subjects were asked to finish the questionnaires of general information,diet status and exercise behaviors and physical examination,be registered value of HbA1 C.Influence factors of HbA1 C were analyzed.Results The compliance rate of diet therapy,exercise therapy and the control rate of HbA1 C respectively were 68.8%,68.85% and 36.07% in T2 DM patients.The subjects under the age of fifty had a lower HbA1 C level than those more than fifty years old [（7.3±1.54）% vs（8.5±2.06）%,P=0.01].The patients with education background below primary school（7.35±1.52）% had a higher HbA1 C level among those with junior middle school education（7.35±1.52）%,high school education（7.45±1.79）% and college degree or above（8.22±2.01）%（P=0.049）.HbA1 C level is not significantly relevant to patients＇ education,smoking,course of diabetes,BMI,diet control and daily exercise period（P〉0.05）.Conclusions The compliance rate of diet therapy,exercise therapy and the control rate of HbA1 C in T2 DM patients are better than before.Strengthening diabetes education might promote the glucose control on the elder T2 DM patients,diabetics with poor education or without diabetes family history.