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目的评价上海崇明县2型糖尿病(T2DM)的控制现状。方法采用随机整群抽样方法从崇明县城桥镇常住居民中抽取40~70岁者共10 060人,其中989人既往被确诊为T2DM患者。参照2010版《中国2型糖尿病防治指南》推荐标准,评价其控制水平。结果 (1)989例T2DM患者平均年龄(56.41±7.78)岁,平均病程(7.41±5.72)年,平均糖化血红蛋白(HbA1c)为(7.60±1.70)%。其中433例(43.78%)患者HbA1c<7%。(2)将989例T2DM患者按照用药情况分成未治疗组(占58.65%)、口服降糖药治疗组(占33.16%)、口服降糖药联合胰岛素治疗组(占4.25%)和胰岛素治疗组(占3.94%),后两组的平均HbA1c明显高于未治疗组,HbA1c达标率明显低于未治疗组,差异有统计学意义(P<0.01)。(3)989例T2DM患者的高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和三酰甘油(TG)水平分别为(1.17±0.30)、(2.63±0.80)和(1.99±1.57)mmol/L,HDL-C、LDL-C和TG均达标者为124例(12.54%);T2DM合并血脂异常者占87.46%,但服用调脂药者仅占0.91%。(4)989例T2DM患者的收缩压(SBP)及舒张压(DBP)分别为(138.45±19.17)和(80.93±9.70)mmHg(1mmHg=0.133kPa),血压<130/80mmHg者占23.46%;T2DM合并高血压者占52.38%,服用降压药者仅占27.70%。(5)989例T2DM患者体质指数(BMI)为(25.17±3.22)kg/m2,BMI<24kg/m2者占36.30%。(6)血糖、血脂、血压、BMI均达标者13例,占1.31%。结论崇明县T2DM患者血糖、血脂、血压、BMI的控制现状明显落后于2010版《中国2型糖尿病防治指南》的推荐标准,胰岛素治疗时机明显滞后。
Objective To evaluate the status of type 2 diabetes mellitus (T2DM) in Chongming County, Shanghai. Methods A total of 10 060 people aged 40-70 years were selected from residents in Chengqiao Town, Chongming County using a random cluster sampling method. 989 of them were previously diagnosed as T2DM. Refer to the 2010 edition of “China Type 2 Diabetes Prevention Guide” recommended standards, evaluate the level of control. Results (1) The average age of 989 T2DM patients was (56.41 ± 7.78) years, the average duration was (7.41 ± 5.72) years, and the average HbA1c was (7.60 ± 1.70)%. 433 (43.78%) of them had HbA1c <7%. (2) 989 T2DM patients were divided into untreated group (58.65%), oral hypoglycemic agents group (33.16%), oral hypoglycemic agents combined with insulin group (4.25%) and insulin treatment group (3.94%). The average HbA1c in the latter two groups was significantly higher than that in the untreated group, and the compliance rate of HbA1c in the latter two groups was significantly lower than that in the untreated group (P <0.01). (3) The levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglyceride (TG) in 989 T2DM patients were (1.17 ± 0.30) and (2.63 ± 0.80) (1.99 ± 1.57) mmol / L, HDL-C, LDL-C and TG were 124 cases (12.54%); T2DM patients with dyslipidemia accounted for 87.46%, but taking lipid-lowering drugs accounted for only 0.91%. (4) The systolic blood pressure (SBP) and diastolic blood pressure (DBP) of 989 T2DM patients were (138.45 ± 19.17) and (80.93 ± 9.70) mmHg respectively (1mmHg = 0.133kPa), and those with blood pressure <130 / 80mmHg accounted for 23.46% T2DM with hypertension accounted for 52.38%, taking antihypertensive drugs accounted for only 27.70%. (5) The body mass index (BMI) of 989 T2DM patients was (25.17 ± 3.22) kg / m2, while the BMI <24 kg / m2 accounted for 36.30%. (6) Blood glucose, blood lipids, blood pressure, BMI were standard in 13 cases, accounting for 1.31%. Conclusion The control status of blood glucose, blood lipids, blood pressure and BMI in T2DM patients in Chongming County lags far behind the recommended standards in Guideline for Prevention and Treatment of Type 2 Diabetes in China in 2010 and lags behind the timing of insulin therapy.