新型冠状病毒肺炎疫情期间糖尿病患者血糖水平的影响因素分析

Analysis of influencing factors of blood glucose levels in diabetic patients during epidemic of COVID-19

目的调查新型冠状病毒肺炎疫情期间糖尿病患者的血糖控制情况,探讨对血糖的影响因素。方法选取空军军医大学第二附属医院2017至2019年在内分泌科住院治疗的糖尿病患者350例,通过微信群向患者投放问卷(共包含39个问题的自制问卷、Zung焦虑自评量表、Zung抑郁量表)。回收有效问卷后,根据患者在疫情期间的血糖情况分为血糖控制良好组(空腹血糖≤7 mmol/L且餐后2 h血糖≤10 mmol/L)和血糖控制不佳组[空腹血糖>7 mmol/L和(或)餐后2 h血糖>10 mmol/L]。采用χ^2检验或Fisher确切概率法、t检验比较2组间资料的差异,多因素logistic回归分析采用后退法。结果共回收问卷310份,剔除不符合要求的4份,共回收有效问卷306份。血糖控制良好组108例(35.3%),血糖控制不佳组198例(64.7%)。与血糖控制良好组相比,血糖控制不佳组中年龄≥45岁、糖尿病病程≥5年、合并糖尿病慢性并发症、疫情期间每周运动时间<150 min、每周监测血糖频率≤1~2次、疫情期间存在睡眠障碍、焦虑、抑郁的差异有统计学意义(P<0.05)。将上述8项P<0.05的因素纳入logistic回归模型中,糖尿病病程≥5年、疫情期间每周运动时间<150 min、疫情期间睡眠障碍、每周监测血糖频率≤1~2次、抑郁是血糖控制不佳的危险因素(P<0.05)。结论疫情期间糖尿病患者的血糖水平整体偏高,影响血糖控制的因素有糖尿病病程较长、运动时间短、测血糖频率较低、睡眠障碍、抑郁等。

Objective To investigate the blood glucose control of diabetic patients during the Coronavirus disease 2019(COVID-19)epidemic,and to explore the factors affecting blood glucose.Methods Three hundred and fifty patients with diabetes mellitus hospitalized in the Endocrinology Department of the Second Affiliated Hospital of Air Force Military Medical University from 2017 to 2019 were selected,and we send questionnaires(a self-made questionnaire containing 39 questions,Zung anxiety self-assessment scale,Zung depression self-assessment scale)to the patients through WeChat group.After the effective questionnaires were collected,the patients were divided into good blood glucose control group(fasting blood glucose≤7 mmol/L and 2 h postprandial blood glucose≤10 mmol/L)and poor blood glucose control group(fasting blood glucose>7 mmol/L and/or 2 hours postprandial blood glucose>10 mmol/L).Chi squaretest or Fisher exact probability method and t test were used to compare the differences between the two groups.In Multi-factor logistic regression,the backward regression method was performed.Results A total of 310 questionnaires were collected,4 of which did not meet the requirements were eliminated,and a total of 306 valid questionnaires were analyzed.There were 108 cases(35.3%)in the well-controlled group and 198 cases(64.7%)in the poorly controlled group.Compared with well-controlled group,there was a higher percentage of patients with aged≥45 years,diabetes course≥5 years,combined with chronic complications of diabetes,weekly exercise time during the epidemic period<150 min,weekly monitoring of blood glucose frequency≤1 to 2 times and sleep disorders during the epidemic,anxiety,and depression in poorly controlled group,and there were statistically significant differences(P<0.05).The above 8 factors with P<0.05 were included in the logistic regression model.Diabetes course≥5 years,weekly exercise time during the epidemic<150 min,sleep disturbance during the epidemic,weekly monitoring of blood glucose frequency≤1 to 2 times,depression were risk factors for poor blood glucose control(P<0.05).Conclusion During the epidemic period,the blood glucose level of diabetes patients was generally high.The factors that affected blood glucose control included a long course of diabetes,short exercise time,low monitoring frequency of blood glucose,sleep disorders,and depression.