老年2型糖尿病患者控糖效果影响因素研究

Influencing Factors of Glucose Control Effects in Elderly Patients with Type 2 Diabetes Mellitus

目的研究老年2型糖尿病(type 2 diabetes mellitus,T2DM)患者控糖效果及其影响因素。方法选取2018年1—12月我院收治的248例老年T2DM患者为研究对象,根据出院后1~3个月空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2 h血糖(2 h PBG)情况分为控糖效果良好组和控糖效果不良组。比较两组性别、年龄、糖尿病病程、文化程度等临床资料,并通过单因素、多因素logistic回归分析探究控糖效果影响因素。结果出院后1~3个月,248例老年T2DM患者FBG、2 h PBG、HbA1c控制达标率分别为40.73%、37.90%、42.34%,三者同时达标92例(控糖效果良好组)占37.10%。多因素logistic回归分析显示,年龄≥75岁、糖尿病病程≥10年、文化程度小学及以下、血压控制未达标、有吸烟史、体育锻炼<1/周是老年T2DM患者控糖效果的影响因素。结论年龄、糖尿病病程、文化程度、血压控制效果、吸烟史、体育锻炼对老年T2DM患者血糖控制有重要影响,临床应对这些因素予以重视,并根据患者具体情况给予合理、针对性的干预措施,以提高患者控糖效果。

Objective To study the glucose control effects and influencing factors in elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 248 elderly patients with T2DM admitted to our hospital from January 2018 to December 2018 were selected for the study.According to the fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc)and postprandial 2 h blood glucose(2 h PBG)during 1-3 months after discharge,they were divided into good glucose control effect group and poor glucose control effect group.The clinical data of gender,age,duration of diabetes and educational level were compared between the two groups,and the factors affecting glucose control effects were explored by univariate and multivariate logistics regression analyses.Results During 1-3 months after discharge,the control rates of FBG,2 h PBG and HbAlc in 248 elderly T2DM patients were 40.73%,37.90%and 42.34%,respectively,and there were 92 cases(good glucose control effect group,37.10%)with the three reaching the standard.Multivariate logistics regression analysis showed that age≥75 years,DM duration≥10 years,primary school education or below,unqualified blood pressure control,smoking and physical exercise<once/w were influencing factors for glucose control effects in elderly T2DM patients.Conclusion Age,DM duration,educational level,blood pressure control,smoking history and physical exercise have important effects on blood glucose control in elderly T2DM patients.It is necessary to pay attention to these factors in clinical practice and provide reasonable and targeted intervention according to the specific conditions of patients so as to improve the glucose control effects of patients.