云南独有少数民族糖尿病患者自我管理现状及其社会经济差异分析

Diabetes self-management among unique ethnic minority diabetic patients in Yunnan province: status and influence of socioeconomic factors

目的 了解云南省纳西族、傈僳族、傣族、景颇族4个独有少数民族糖尿病患者的自我管理现状及其社会经济差异,为今后少数民族地区开展糖尿病自我管理干预提供参考依据。方法 于2013年8月—2014年8月采用多阶段分层随机抽样方法,在云南省玉龙县、永胜县和德宏傣族景颇族自治州抽取5 532名≥35岁的纳西族、傈僳族、傣族和景颇族4个独有少数民族常住居民进行问卷调查和血糖检测。结果 云南省5 532名≥35岁纳西族、傈僳族、傣族和景颇族居民中,自我报告糖尿病患病167例,糖尿病自我报告患病率为3.02%;糖尿病患者的自我监测血糖率、遵医嘱用药率、控制饮食率、增加体育锻炼率、控制体重或减肥率和戒烟率分别是36.5%、68.9%、82.6%、18.0%、37.1%和7.8%;在控制了年龄、性别、民族等混杂因素后,多因素非条件logistic回归分析结果显示,中等偏上社会经济地位者和高社会经济地位者自我监测血糖的可能性分别为低社会经济地位者的1.91倍（OR=1.91,95%CI=1.03~3.50）和2.02倍（OR=2.02,95%CI=1.32~3.11）,遵医嘱用药的可能性分别为低社会经济地位者的2.13倍（OR=2.13,95%CI=1.29~3.52）和1.97倍（OR=1.97,95%CI=1.37~2.83）。结论 云南省纳西族、傈僳族、傣族、景颇族4个独有少数民族糖尿病患者的自我管理水平总体较低,且存在明显的社会经济差异。

Objective To examine current situation of diabetes self-management and influence of socioeconomic status among ethnic minority diabetic patients of Naxi, Lisu, Dai, and Jingpo in Yunnan province, and to provide refer- ences for intervention on diabetes self-management in the populations. Methods Multi-stage stratified random sampling was used to selected a representative sample of 5 532 Naxi, Lisu, Dai, and Jingpo residents aged 35 and over in Yulong and Yongsheng county and Dehong Dai and Jingpo Autonomous Prefecture in Yunnan province. Information were ob- tained via a questionnaire survey and blood glucose test among all participants. Results The self-reported prevalence rate of diabetes was 3.02% （ 167/5 532） among the participants. Among the diabetic patients, the rate of self-monitoring blood glucose （SMBG）, medication adherence, diet control, weight control or weight loss, and smoking cessation was 36. 5 %, 68.9% ,82. 6% ,18. 0% ,37.1% ,and 7. 8% ,respectively. After controlling for confounding factors（age,sex,ethnic） ,the results of multivariate logistic regression analysis showed that the diabetic patients with mid-high and high socioeconomic status （SES） were more likely to have SMBG （ odds ratio [ OR ] = 1.91 and 2.02 ） ） and medication adherence （ OR = 2. 13 and 1.97 ） compared to those with low SES. Conclusion The rate of diabetes self-management is low among ethnic minority diabetic patients of Naxi, Lisu, Dai, and Jingpo in Yunnan province and influenced by socioeconomic status of the patients.