部队老干部2型糖尿病降糖治疗方案与血糖控制情况分析

目的调查空军驻京部队老干部中2型糖尿病（T2DM）患者的降糖治疗方案应用及血糖控制情况,并分析治疗方案与血糖控制之间的关系。方法采用调查问卷形式采集患者的基本情况、降糖方案、依从性等,抽血查空腹（FPG）、餐后2h血糖（2hPG）、糖化血红蛋白（HbA1c）。按HbA1c水平分为达标组（HbA1c〈7.0）和未达标组（HbA1c≥7.0）;再按降糖治疗方案情况分为生活方式口服降糖药、胰岛素组、胰岛素联合口服药组。结果共调查患者303例,治疗依从率为65.0%,HbA1c（7.0±1.2）%,控制理想者（HbA1c〈7.0%）占56.1%。治疗方案的选择上应用单纯口服药治疗者最多占57.1%,此组治疗方案依从性也最高。胰岛素组与胰岛素联合口服药组HbA1c均值、HbA1c未达标患者、病程均高于口服药治疗组,治疗依从性则远低于口服药治疗组。结论部队老干部2型糖尿病治疗方案的选择基本合理,血糖控制水平及依从性均优于或不差于国内、外水平。对于老年患者,在血糖控制理想的情况下,尽可能选择简单易操作的治疗方案。

THE STATUS OF THERAPEUTIC SCHEDULE OF BLOOD GLUCOSE CONTROL AMONG THE FORCE VETERAN CADRES WITH TYPE 2 DIABETES

Objective To investigate the therapeutic schedule and the state of blood glucose control of the air force troops veteran cadres with type 2 diabetes and to analyze the relation between them.Methods Questionnaires were used to collect the patients＇ basic situation,therapeutic schedule,compliance and so on.Blood was drawn to examine the fasting blood glucose（FFG）,postprandial 2 hours blood glucose（2 HPG）and glycosylated hemoglobin（HbA1c）.The 303investigated patients were divided into two groups according to the glycosylated hemoglobin：the group up to the standard（HbA1c〈7.0%）and the group not up to the standard（HbA1c≥7.0%）.According to the therapeutic schedule,all patients were divided into the following three groups：lifestyle oral medications group,insulin group and insulin plus oral medication group.Results The treating compliance rate was 65% and patients with ideal glycosylated hemoglobin（HbA1c 〈7.0%）accounted for 56.1%among 303 patients.The patients who applied the simple oral medications accounted for 57.1%and they also had the best compliance.The rate whose average glycated hemoglobin,glycosylated hemoglobin not up to standard in the insulin and insulin combined oral medications groups were higher than that in the patients with oral medications group,and their course of the disease were also longer, whose compliance was far lower than the oral medications group.Conclusions The therapeutic schedule of the air forces veteran cadres with type 2 diabetes is basically reasonable,the level of blood glucose control and compliance are better or not worse than that in domestic and abroad.For the elderly patients,simply and easily operated treatment can be chosen in the case of ideal blood glucose control as far as possible.