云南少数民族糖尿病患病和管理的社会经济影响因素

目的 分析云南四个独有少数民族糖尿病患病、知晓、治疗和自我管理的社会经济影响因素。方法 对云南省≥35岁的纳西族、傈僳族、傣族和景颇族村民，采用多阶段分层抽样方法抽取5 600人进行问卷调查和体检。应用多水平模型分析影响糖尿病患病和管理的社会经济因素。结果 糖尿病的总体患病率、知晓率、治疗率和控制率分别为4.7%、63.7%、48.1%和24.8%；糖尿病病人采取降糖措施率、遵医嘱用药率和监测血糖率分别为91.0%、68.9%和36.5%。教育水平和家庭财产越高以及医疗服务可及性越好的糖尿病病人，其治疗率越高。居住在收入越高乡镇者患糖尿病的风险越大，患病后治疗的可能性也越高。教育水平越高、医疗服务可及性越好及居住在高收入乡镇者更易遵医嘱用药；教育水平和家庭财产越高以及居住在教育水平较高乡镇者监测血糖率越高。在高收入乡镇，其糖尿病病人采取降糖措施的可能性也越大。结论 云南独有少数民族地区糖尿病的预防和干预工作应同时考虑个体和乡级社会经济影响因素。

Socioeconomic influence on prevalence and management of diabetes among ethnic minorities in Yunnan Province

Objective To analyze socioeconomic influences on prevalence, awareness, treatment and self-management of diabetes among four unique ethnic minorities in Yunnan Province. Methods Using multi-stage stratified random sampling method, we chose a representative sample of 5 600 residents aged 35 and over from Naxi, Lisu, Dai and Jingpo ethnic minorities in Yunnan Province. A questionnaire survey and physical examination were performed among all participants. Multilevel analysis was used to examine socioeconomic factors on prevalence, awareness, treatment and self-management of diabetes. Results The overall prevalence, awareness, treatment and control rate of diabetes was 4.7%, 63.7%, 48.1% and 24.8%, respectively. Among diabetic patients, the rate of taking measures to lower glucose, medication adherence, and monitoring blood glucose was 91.0%, 68.9% and 36.5%, respectively. Diabetic patients with higher levels of education,with higher household assets and better access to medical service had higher treatment rate. Residents from a higher-income township were more likely to be diabetic, and have a higher treatment rate. Diabetic patients with higher educational level, better access to medical service, and living in a higher-income township had a greater probability of compliance to prescribed medicines. Diabetic patients with higher educational level, higher household assets, and living in a township with higher educational level were more likely to monitor blood glucose. Diabetic patients from a higher-income township were more likely to take measures to lower glucose. Conclusions Future prevention and intervention programs for diabetes should be focused on both individual-level and township-level socioeconomic factors in ethnic minorities areas of Yunnan Province.