北京市15个城区社区3297例成人2型糖尿病患者降糖药物治疗现状的调查:北京社区糖尿病研究7
북경시15개성구사구3297례성인2형당뇨병환자강당약물치료현상적조사:북경사구당뇨병연구7
Current status of hypoglycemic drug use among 3297 adult patients with type 2 diabetes in 15 urban communities of Beijing：Beiiing Community Diabetes Study-7
  • 万方数据
    中华全科医师杂志 중화전과의사잡지
    CHINESE JOURNAL OF GENERAL PRACTITIONERS
    2011年 11期 796-800 ,共5页

    李彬%傅汉菁%袁申元%朱良湘%杨金奎%万钢%潘素芳%于湄%卜祥雷%张建东%杜雪平%李玉玲%季宇%谷晓宁%李月%崔学利%白薇%陈玉洁%王自明%朱庆生%高迎%柳德元%王益品

    리빈%부한정%원신원%주량상%양금규%만강%반소방%우미%복상뢰%장건동%두설평%리옥령%계우%곡효저%리월%최학리%백미%진옥길%왕자명%주경생%고영%류덕원%왕익품

    社区%糖尿病,2型%糖化血红蛋白%胰岛素 社區%糖尿病,2型%糖化血紅蛋白%胰島素
    사구%당뇨병,2형%당화혈홍단백%이도소
    Community%Diabetes mellitus,type 2%Glycosylated hemoglobin%Insulin
    目的 了解北京城市社区2型糖尿病患者降糖药物的应用现状.方法 对在北京市5个城区的15个社区卫生服务中心治疗的3297例2型糖尿病成人患者,行体重、身高及血糖控制指标的检测,降糖药物的使用情况的问卷调查.按应用药物情况分为生活方式干预组、单种口服降糖药组、多种口服降糖药组和胰岛素组,分别为454、971、1179和693例.结果 ①329例中,生活方式干预占13.8％(454/3297),单种口服降糖药占29.5％ (971/3297),多种口服降糖药占35.7％( 1179/3297),胰岛素占21.0％ (693/3297).②4组的平均糖化血红蛋白(HbAIc)依次升高,分别为(7.0±1.9)、(7.1±1.5)、(7.4±1.5)和(7.5±1.5)％(F=15.1,P＜0.01)；HbAlc≥7.0％的比例依次增加,分别为32.2％、39.4％、52.1％和59.5％(x2=117.7,P＜0.01).③生活方式干预组中32.2％( 146/454)患者HbAlc≥7.0％,尚未应用降糖药物治疗；单种口服降糖药组中39.4％(383/971)患者HbAIc≥7.0％,尚未联合多种口服药或胰岛素治疗；多种口服降糖药组中52.1％ (614/1179)患者HbAIc≥7.0％,尚未联合胰岛素治疗.④空腹血糖、治疗策略、餐后2h血糖和糖尿病病程为HbAlc≥7.0％的独立危险因素,其比值比分别为1.757、1.256、1.175和1.031.⑤在2843例应用降糖药患者中,应用二甲双胍占52.6％(1494/2843),应用胰岛素占24.4％ (693/2843).结论 北京社区成人2型糖尿病患者一半以上HbAIc达标,但用药中存在未积极应用口服降糖药、不及时采用多药联合和胰岛素治疗等问题.
    목적 료해북경성시사구2형당뇨병환자강당약물적응용현상.방법 대재북경시5개성구적15개사구위생복무중심치료적3297례2형당뇨병성인환자,행체중、신고급혈당공제지표적검측,강당약물적사용정황적문권조사.안응용약물정황분위생활방식간예조、단충구복강당약조、다충구복강당약조화이도소조,분별위454、971、1179화693례.결과 ①329례중,생활방식간예점13.8％(454/3297),단충구복강당약점29.5％ (971/3297),다충구복강당약점35.7％( 1179/3297),이도소점21.0％ (693/3297).②4조적평균당화혈홍단백(HbAIc)의차승고,분별위(7.0±1.9)、(7.1±1.5)、(7.4±1.5)화(7.5±1.5)％(F=15.1,P＜0.01)；HbAlc≥7.0％적비례의차증가,분별위32.2％、39.4％、52.1％화59.5％(x2=117.7,P＜0.01).③생활방식간예조중32.2％( 146/454)환자HbAlc≥7.0％,상미응용강당약물치료；단충구복강당약조중39.4％(383/971)환자HbAIc≥7.0％,상미연합다충구복약혹이도소치료；다충구복강당약조중52.1％ (614/1179)환자HbAIc≥7.0％,상미연합이도소치료.④공복혈당、치료책략、찬후2h혈당화당뇨병병정위HbAlc≥7.0％적독립위험인소,기비치비분별위1.757、1.256、1.175화1.031.⑤재2843례응용강당약환자중,응용이갑쌍고점52.6％(1494/2843),응용이도소점24.4％ (693/2843).결론 북경사구성인2형당뇨병환자일반이상HbAIc체표,단용약중존재미적겁응용구복강당약、불급시채용다약연합화이도소치료등문제.
    Objective To investigate current status of use of oral hypoglycemic drugs and insulin among adult patients with type 2 diabetes mellitus (T2DM) in urban community of Beijing.Methods In total,3297 T2DM patients aged more than 20 years from 15 urban communities of Beijing were studied.Their body weight,height,fasting plasma glucose level and glycosylated hemoglobin Alc (HbAlc) were measured.A door-to-door questionnaire survey on use of oral hypoglycemic drugs and insulin was conducted for them.All the T2DM patients surveyed were divided into four groups based on their received intervention.Results ①Of 3279 T2DM patients,454 (13.8％) received lifestyle intervention,971 (29.5％) used only one oral hypoglycemic drug,1179 (35.7％) with combined oral hypoglycemic drugs,and 693(21.0％) with insulin.②There was significant difference in average HbAlc among the four groups of T2DM patients with lifestyle intervention,only one oral hypoglycemic drug,combined oral hypoglycemic drugs,and insulin,with HbAI c of (7.0 ± 1.9) ％,(7.1 ± 1.5) ％,(7.4 ± 1.5 ) ％,and (7.5 ± 1.5 ) ％for them,respectively ( F =15.1,P ＜ 0.01 ).Proportions of the T2DM patients with HbAlc equal to or higher than 7.0％ were 32.2％,39.4％,52.1％ and 59.5％ for the four groups,respectively ( x2 =117.7,P ＜ 0.01 ).③In the T2DM patients with lifestyle intervention,32.2％ (146/454) of them with HbA1 c equal to or higher than 7.0％ were untreated with any oral hypoglycemic drug.In those with only one oral hypoglycemic drug,39.4％ (383/971) of them with HbAlc equal to or higher than 7.0％ were not treated with combined oral hypoglycemic drugs and/or insulin.In those with combined oral hypoglycemic drugs,52.1％ (614/1079) of them with HbAlc equal to or higher than 7.0％ were not received combined insulin treatment.④ Fasting plasma glucose level,treatment strategies,postprandial 2-h blood glucose level and length of the illness were independent risk factors for HbAlc level equal to or higher than 7.0％,with odds ratio (OR) of 1.757,1.256,1.175 and 1.031,respectively.⑤ In 2843 T2DM patients with oral hypoglycemie drugs and/or insulin treatment,1494 (52.6％ ) received biguanides and 693 received (24.4％ )insulin,respectively.Conclusions More than half of adult patients with T2DM do not meet the target of glycemic control of HbAlc less than 7.0％ in urban communities of Beijing,due to not active use of oral hypoglycemic drugs,and not timely adoption of combined use of oral hypoglycemic drugs and insulin therapy.
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