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目的了解北京社区2型糖尿病患者HbA_1c水平控制现状,分析相关影响因素。方法采用多级抽样方法,纳入北京市5个城区中15个社区卫生服务中心2477例2型糖尿病患者。全体参与专门培训后,按操作规范对患者进行体格检查及相关实验室检查,填写调查表。结果 (1)HbA_1c<6.5%者788例,占31.8%;HbA_1c≥6.5%者1689例,占68.2%。(2)不同HbA_1c水平组,其年龄、糖尿病病程、体质指数、腰围、血压、空腹血糖、甘油三脂、总胆固醇、低密度脂蛋白胆固醇、经济水平、文化程度间差异均有统计学意义。(3)经调整相关因素影响后,文化程度对HbA_1c水平有独立影响。结论北京市社区2型糖尿病患者血糖控制达标现状不容乐观。血糖控制受到多种因素影响,其中文化程度低是独立危险因素。提示糖尿病社区管理应该更加注重个体化,对较低文化水平的患者人群应给予更多关怀。
Objective To understand the status of HbA 1c level control in type 2 diabetes in Beijing community and to analyze the related factors. Methods A total of 2477 patients with type 2 diabetes mellitus were enrolled in 15 community health service centers in 5 urban districts of Beijing using multistage sampling. All involved in specialized training, according to the norms of patients with physical examination and related laboratory tests, fill out the questionnaire. Results (1) HbA_1c <6.5%, 788 cases, accounting for 31.8%; HbA_1c≥6.5%, 1689 cases, accounting for 68.2%. (2) There were significant differences in age, duration of diabetes, body mass index, waist circumference, blood pressure, fasting blood glucose, triglycerides, total cholesterol, LDL cholesterol, economic level and educational level among different HbA_1c groups. (3) The educational level has an independent influence on the level of HbA_1c after the adjustment of related factors. Conclusion The status of glycemic control in patients with type 2 diabetes mellitus in Beijing community is not optimistic. Blood sugar control is affected by many factors, of which low education level is an independent risk factor. Suggest that diabetes community management should pay more attention to individualization, and should give more care to patients with lower education level.