崇明县2型糖尿病控制现状调查和分析

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(HbA_1c)为(7.60±1.70)%。其中433例(43.78%)患者HbA_1c<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HbA_1c明显高于未治疗组, HbA_1c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 (1 mmHg=0.133 kPa),血压＜130/80 mmHg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＜24 kg/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。

Controlling status of type 2 diabetes in Chongming County: a survey

Objective To evaluate the controlling status of type 2 diabetes (T2DM) in Chongming County, a suburban region of Shanghai. Methods A total of 10,060 residents were selected from the Chengqiao Town of Chongming County by using random cluster sampling, and the subjects ranged in age 40-70 years old, with 989 of them previously diagnosed as T2DM patients. The level of control was evaluated according to Chinese Type 2 Diabetes Prevention Guidelines (2010 version). Results (1) The 989 patients with T2DM had an average age of (56.41±7.78) years, a mean disease duration of (7.41±5.72) years and an average hemoglobin A_1c (HbA_1c) level of (7.60±1.70)%. And 433(43.78%) patients had HbA_1c<7%. (2) The patients were divided into untreated group (accounting for 58.65%), oral hypoglycemic therapy group (33.16%), oral hypoglycemic agents plus insulin treatment group (4.25%), and insulin-treated group (3.94%); the average HbA_1c levels of the latter two groups were significantly higher than that of the untreated group, and the HbA_1c compliance rates were significantly lower than that of the untreated group (P<0.01). (3) For the 989 patients, the mean high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triacylglycerol (TG) were (1.17±0.30), (2.63±0.80) and (1.99±1.57) mmol/L, respectively; and 124(12.54%) patients had their HDL-C, LDL-C, and TG levels meeting the standard. We also found that 87.46% of the patients had diabetic dyslipidemia, but only 0.91% of them were taking lipid-lowering drugs. (4) For the 989 patients, the mean systolic blood pressure (SBP) was (138.45±19.17) mmHg (1 mmHg=0.133 kPa) and the diastolic blood pressure (DBP) was (80.93±9.70) mmHg, with 23.46% of them having blood pressure <130/80 mmHg, 52.38% also having hypertension, and 27.70% taking antihypertensive drugs. (5) The average body mass index (BMI) of the patients was (25.17±3.22) kg/m², with those BMI<24 kg/m² accounting for 36.30%. (6) Totally 13 (1.31%) patients had their glucose, blood lipids, blood pressure, and BMI meeting the standard. Conclusion The control of blood sugar, blood lipids, blood pressure, and BMI of T2DM patients in our sample are greatly behind those required by Chinese Type 2 Diabetes Prevention Guidelines (2010 version), and the starting time of insulin treatment has lagged far behind.