社区2型糖尿病患者血糖自我管理水平调查及并发糖尿病周围神经病变的影响因素分析

Investigation of Blood Sugar Self-management Level in Community Patients with Type 2 Diabetes Mellitus and Analysis of Influencing Factors of Diabetic Peripheral Neuropathy

目的:调查社区2型糖尿病(T2DM)患者血糖自我管理水平及分析T2DM并发糖尿病周围神经病变(DPN)的影响因素。方法:于2016年6月~2017年6月期间采用整群随机抽样法随机抽取苏州市6个社区符合纳排标准的539例T2DM患者进行问卷调查,了解社区T2DM患者血糖自我管理水平情况,对患者进行体格检查并检测血生化指标,统计社区T2DM患者的DPN发生情况,采用多因素logistic回归分析T2DM患者并发DPN的影响因素。结果:本次研究共发放调查问卷539份,实际回收531份,其中T2DM并发DPN者86例,根据是否并发DPN将所有入选患者分为DPN组(n=86)和无DPN组(n=445)。社区T2DM患者的糖尿病自我管理行为量表(SDSCA)平均得分率为(49.38±5.23)%,DPN组和无DPN组在病程、体质量指数(BMI)、腰围、糖化血红蛋白(HbAlc)、空腹胰岛素(FINS)、低密度脂蛋白(LDL-C)、血尿素氮(BUN)、血肌酐(Cr)、合并外周动脉疾病(PAD)、合并糖尿病视网膜病变(DR)中比较差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示:病程≥7年、HbAlc≥8 mmol/L、合并PAD、合并DR、BMI≥25 kg/m2是社区T2DM患者并发DPN的危险因素(P<0.05)。结论:苏州市6个社区的T2DM患者血糖自我管理水平较低,且T2DM并发DPN的概率较高,病程≥7年、HbAlc≥8 mmol/L、合并PAD、合并DR、BMI≥25 kg/m2均是社区T2DM患者并发DPN的危险因素,临床可对上述危险因素采取积极有效的措施,以有效降低T2DM并发DPN的发生率。

Objective:To investigate the level of blood sugar self-management in community patients with type 2 diabetes mellitus(T2DM)and to analyze the influencing factors of diabetic peripheral neuropathy(DPN)in patients with T2DM.Methods:Using cluster random sampling method,539 patients with T2DM in 6 communities of Suzhou from June 2016 to June 2017 were investigated by questionnaires.The level of blood glucose self-management in community patients with T2DM was understanded,physical examination and blood biochemistry were performed.The occurrence of DPN in community patients with T2DM was statistically analyzed,Multivariate logistic regression was used to analyze the influencing factors of DPN in patients with T2DM.Results:539 questionnaires were sent out in this study,531 cases were actually recovered,of which 86 cases were complicated with DPN in T2DM.All patients were divided into DPN group(n=86)and non-DPN group(n=445)according to whether DPN was concurrent or not.The average score of summary of diabetes self-care activities scale(SDSCA)in community patients with T2DM was(49.38±5.23)%.There were significant differences in course of disease,body mass index(BMI),waist circumference,glycosylated hemoglobin(HbAlc),fasting insulin(FINS),low density lipoprotein(LDL-C),blood urea nitrogen(BUN),serum creatinine(Cr),complicated with peripheral arterial disease(PAD),complicated with diabetic retinopathy(DR)between DPN group and non-DPN group(P<0.05).Multivariate Logistic regression analysis showed that course of disease≥7 years,HbAlc≥8 mmol/L,complicated with PAD,complicated with DR and BMI≥25 kg/m2 were risk factors for DPN in community patients with T2DM(P<0.05).Conclusion:The level of blood glucose self-management in patients with T2DM in 6 communities in Suzhou is low,and the probability of T2DM complicated with DPN is high.The course of disease≥7 years,HbAl≥8 mmol/L,complicated with PAD,complicated with DR and BMI≥25 kg/m2 are all risk factors of DPN in community patients with T2DM.Clinical measures can be taken to effectively reduce the incidence of DPN in patients with T2DM.