影响2型糖尿病患者治疗及血糖达标的影响因素分析

Analysis of Influential Factors on Treatment of Patients with Type 2 Diabetes and Target of Blood Glucose Control

目的:了解2型糖尿病患者药物治疗现状,探讨影响血糖达标的因素。方法:选取2014年通辽市第二人民医院内分泌科收治的2型糖尿病患者340例,采取问卷调查的方式,了解患者药物治疗情况及自我管理行为情况,评估药物治疗的效果及影响血糖达标的因素。结果:340例2型糖尿病患者的空腹血糖、餐后2 h血糖及糖化血红蛋白水平达标率分别为37.06%(126/340)、25.00%(85/340)和39.12%(133/340);85.59%的患者(291例)接受了药物治疗,使用频率较高的药物为双胍类、硫脲类及胰岛素。自我管理方面,患者用药行为及接受糖尿病教育的依从性不高,多因素分析结果显示,"医保"类型、患者性别、用药行为、接受糖尿病教育及控制饮食是血糖达标的保护因素,病程是血糖达标的危险因素。结论:2型糖尿病患者血糖控制不够理想,患者的用药行为、饮食控制及接受糖尿病健康教育方面有待提高。因此,对2型糖尿病患者提供综合的药学服务,使其了解糖尿病相关知识、掌握抗糖尿病药的使用方法、规范用药行为、执行正确的药物治疗方案十分必要。

OBJECTIVE： To investigate the current medication situation of patients with type 2 diabetes,and to probe into the influential factors on the target of blood glucose control. METHODS： 340 cases with type 2 diabetes admitted to endocrinology department of the Second People＇s Hospital of Tongliao in 2014 were selected,according to the questionnaire survey,to investigate the medication treatment and self management condition of the patients; the outcome of medication treatment and the influential factors of target of blood glucose control were evaluated. RESULTS： The target rates of fasting blood glucose,postprandial blood glucose after 2 h and glycated hemoglobin levels of 340 cases with type 2 diabetes were37. 06%（ 126 /340）,25. 00%（ 85 /340） and 39. 12%（ 133 /340）,respectively; 85. 59% of the patients（ 291 cases） received medication treatment,and the utilization frequency of biguanides,thioamide and insulin were relatively high. As for self management,the compliance of drug use behavior for patients and acceptance of the diabetes education were relatively low;analysis of multiple factors revealed that types of health care,patients＇ gender,drug use behavior and acceptance of the diabetes education and diet control were the protective factors of target of blood glucose control,and course of disease was the risk factor of target of blood glucose control. CONCLUSIONS： The blood glucose control of patients with type 2 diabetes is far from ideal,and drug use behavior for patients,diet control and acceptance of the diabetes education need to be improved.Therefore,it is necessary to provide integrated pharmaceutical care for the patients with type 2 diabetes,make them know more about the diabetes knowledge,then master the usage of antidiabetic drugs,and regulate the drug use behavior and execute the correct medication treatment.