2型糖尿病患者行为依从性及血糖控制达标现状调查

目的 调查2型糖尿病患者行为依从性及血糖控制达标现状,为2型糖尿病患者血糖控制及行为干预提供参考资料。方法 2020年10月至2021年12月以与某三甲医院合作的社区卫生服务中心登记在册的2型糖尿病患者作为研究对象,以调查问卷方式获取其基本资料及行为依从性情况,检测血生化指标评估血糖控制达标情况,分析2型糖尿病患者行为依从性对血糖达标的影响。结果 共纳入研究对象1 949例,有效研究对象1 872例,有效率96.05%。血糖控制达标1 021例,达标率54.54%。不同年龄、文化水平、病程、其他基础疾病的2型糖尿病患者血糖达标率比较,差异均有统计学意义（P<0.05或P<0.01）。遵医嘱用药、控制饮食种类、按时进餐、经常参加体育锻炼、戒烟、戒酒、保证睡眠时间、血糖监测依从性良好率分别为64.37%、52.67%、58.49%、49.79%、82.43%、78.69%、76.87%、48.13%。多因素Logistic回归分析提示年龄（OR=0.779）、文化水平（OR=2.257）、病程（OR=0.689）、其他基础疾病（OR=0.483）、遵医嘱用药（OR=3.543）、控制饮食种类（OR=2.675）、按时进餐（OR=1.988）、经常参加体育锻炼（OR=2.054）、戒酒（OR=2.208）、血糖监测（OR=1.960）是2型糖尿病患者血糖控制达标率的影响因素。结论 2型糖尿病患者行为依从性有待提升,尤其遵医嘱用药、控制饮食种类、按时进餐、经常参加体育锻炼、戒酒、血糖监测依从性与血糖控制达标率密相关,应加强针对性干预对策,提高患者行为依从性,控制2型糖尿病病情发展。

Investigation on compliance of behavior and blood glucose control in patients with type 2 diabetes mellitus

Objective To investigate the compliance of behavior and blood glucose control in patients with type 2 diabetes mellitus （T2DM）, and to provide a reference for blood glucose control and behavior intervention in T2DM patients. Methods From October 2020 to December 2021, the T2DM patients who were registered in a community service center cooperated with a tertiary hospital were selected. The basic data and behavioral compliance were obtained by questionnaire. The blood biochemical indexes of examination were used to evaluate the compliance of blood glucose control. The impact of behavioral compliance on blood glucose compliance in T2DM patients was analyzed. Results A total of 1 949 patients were included, 1 872 cases were effective, and the effective rate was 96.05%. There were 1 021 cases of blood glucose control that reached the standard, with a rate of 54.54%. There were statistically significant differences in compliance rates of blood glucose control among T2DM patients at different ages, educational levels, course of the disease, and other basic diseases （P＜0.05 or P＜0.01）. The compliance rates of medication following the doctor's advice, diet control, meals on time, regular physical exercise, smoking cessation, alcohol withdrawal, sleep guarantee, and blood glucose monitoring were 64.37%, 52.67%, 58.49%, 49.79%, 82.43%, 78.69%, 76.87%, 48.13%, respectively. Multivariate Logistic regression analysis showed that age （OR＝0.779）, educational level （OR＝2.257）, course of disease （OR＝0.689）, other basic diseases （OR＝0.483）, medication following the doctor's advice （OR＝3.543）, diet control （OR＝2.675）, meals on time （OR＝1.988）, regular physical exercise （OR＝2.054）, alcohol withdrawal （OR＝2.208）, and blood glucose monitoring （OR＝1.960） were the influencing factors of blood glucose control compliance in T2DM patients. Conclusions The behavioral compliance of T2DM patients need to be improved. In particular, compliance of medication following the doctor's advice, diet control, meals on time, regular physical exercise, alcohol withdrawal, and blood glucose monitoring are closely related to the compliance rate of blood glucose control. Targeted intervention measures should be strengthened to improve the behavioral compliance of patients and control the development of T2DM.