1909例2型糖尿病患者血糖控制现状及微血管并发症发生情况

Current status of glycemic control and occurrence of microvascular complications in 1909 patients with type 2 diabetes

目的探讨2型糖尿病(T2DM)患者血糖控制现状及微血管并发症发生情况。方法采用整群随机抽样横断面调查。对2019年3—5月江苏阜宁县2067例50岁及以上T2DM患者进行问卷调查、体格检查、HbA1c检测和眼科检查。根据血糖控制目标(HbA1c<7.0%)将患者分为血糖控制达标组和血糖控制不达标组,比较两组不同临床特征对血糖控制达标率的影响。采用单因素和多因素logistic回归分析血糖控制达标的影响因素。比较两组患者糖尿病微血管并发症患病率。结果调查资料完整纳入分析的T2DM患者1909例,其HbA1c为(7.90±2.18)%。其中,血糖控制达标组799例(41.85%)。年龄、家庭人均月收入、婚姻、饮酒、糖尿病家族史、病程和治疗方式与血糖控制密切相关(P<0.05或P<0.01)。多因素logistic回归分析显示,年龄≥80岁和家庭人均月收入>2000元是血糖控制达标的保护因素(P<0.01);已戒酒、病程≥6年和采用药物治疗是血糖控制达标的危险因素(P<0.05或P<0.01)。血糖控制达标组糖尿病视网膜病变、糖尿病黄斑水肿、糖尿病肾病和糖尿病足患病率均低于血糖控制不达标组(P<0.05或P<0.01)。结论江苏阜宁县50岁及以上T2DM患者血糖控制达标情况居于全国中上水平。对病程较长、需要药物控制血糖的患者应加强用药指导和血糖监测,以减少微血管并发症发生。

Objective To investigate the current status of glycemic control and occurrence of microvascular complications in 2067 patients with type 2 diabetes(T2DM).Methods A cross-sectional survey with cluster random sampling was conducted in Funing County,Jiangsu province from March to May in 2019.All the T2DM patients were aged 50 years old or above and received comprehensive questionnaire and the examinations including ocular examination,physical examination and glycosylated hemoglobin A1c(HbA1c)testing.According to the criteria of glycemic control(HbA1c<7.0%),the patients were divided into two groups of A(standard group)and B(substandard group).Univariate and multivariate logistic regression analysises were used to analyze the influencing factors of glycemic control.The prevalence of microvascular complications of diabetes was compared between the two groups.Results The data of 1909 T2DM patients were finally eligible for inclusion with an average level of HbA1c(7.90±2.18)%,of whom 799 patients(41.85%)had good glycemic control.The factors of age,family income,marriage,alcohol consumption,family history of diabetes,course of disease and hypoglycemic therapy were closely related to glycemic control(P<0.05 or P<0.01).Multivariate logistic regression analysis showed that age≥80 years old and family per capita monthly income>2000 yuan were the protective factors for good glucose control(P<0.01),while ever drinking,course of diabetes≥6 years and drug therapy were the risk factors for good glucose control(P<0.05 or P<0.01).The morbidity rates of diabetic retinopathy,diabetic macular edema,diabetic nephropathy and diabetic foot were significantly lower in group A than those in group B(P<0.05 or P<0.01).Conclusion The blood glucose control standard of T2DM patients aged 50 years or above in Funing County,Jiangsu province is at the upper middle level in China.For the patients with longer diabetes course and needing drug to control blood glucose,the medication guidance and blood glucose monitoring for blood glucose control should be strengthened to reduce the occurrence of microvascular complications.