CAJ | 학술논문

目的了解广东省超重肥胖2型糖尿病(T2DM)患者血糖控制现状和相关影响因素.方法 2011年8月至2012年3月在广东省内60家二级以上医院门诊就诊或住院的已确诊T2DM且合并超重或肥胖的常住居民进行横断面调查,共纳入调查超重肥胖T2DM患者5241例,通过填写调查问卷和体格检查的方式获取患者临床资料,了解影响血糖控制的因素.以糖化血红蛋白(HbA1c)评价血糖控制水平,以HbA1c ＜7.0％为血糖控制达标.结果 4768例完成研究,其中男2252例,女2516例.患者年龄59.0(50.0 ～69.0)岁；发病年龄52.0(44.0 ～60.0)岁；病程5.0(2.0 ～ 11.0)年.体质指数(BMI)为26.33(24.88 ～ 28.34) kg/m2；腰围为93.0(88.0～ 100.0) cm.HbA1c为8.1％(6.9％～10.1％),仅26.2％的超重肥胖T2DM患者HbA1c达到控制目标.向心性肥胖、静息心率偏快、合并脂肪肝及糖尿病治疗强度大的患者血糖控制差；规律运动、戒烟、定期监测血糖、血脂达标的患者血糖控制较好.结论广东省大多数超重肥胖T2DM患者血糖控制未达标,迫切需要采取积极措施改善这一现况.
목적 료해광동성초중비반2형당뇨병(T2DM)환자혈당공제현상화상관영향인소.방법 2011년8월지2012년3월재광동성내60가이급이상의원문진취진혹주원적이학진T2DM차합병초중혹비반적상주거민진행횡단면조사,공납입조사초중비반T2DM환자5241례,통과전사조사문권화체격검사적방식획취환자림상자료,료해영향혈당공제적인소.이당화혈홍단백(HbA1c)평개혈당공제수평,이HbA1c ＜7.0％위혈당공제체표.결과 4768례완성연구,기중남2252례,녀2516례.환자년령59.0(50.0 ～69.0)세；발병년령52.0(44.0 ～60.0)세；병정5.0(2.0 ～ 11.0)년.체질지수(BMI)위26.33(24.88 ～ 28.34) kg/m2；요위위93.0(88.0～ 100.0) cm.HbA1c위8.1％(6.9％～10.1％),부26.2％적초중비반T2DM환자HbA1c체도공제목표.향심성비반、정식심솔편쾌、합병지방간급당뇨병치료강도대적환자혈당공제차；규률운동、계연、정기감측혈당、혈지체표적환자혈당공제교호.결론 광동성대다수초중비반T2DM환자혈당공제미체표,박절수요채취적겁조시개선저일현황.
Objective To explore the glycemic control status and related risk factors of overweight or obesity patients with type 2 diabetes mellitus (T2DM) in Guangdong province.Methods The medical records of overweight or obesity patients with T2DM from 60 tertiary and secondary hospitals in Guangdong Province were collected by questionnaire and physical examination.And the clinical data were analyzed to explore the influencing factors of glycemic control.The HbA1c level was used to assess glycemic control.HBA1c ＜7.0％ indicated that glycemic control was up to standard.Results From August 2011 to March 2012,5241 T2DM patients were recruited.The scope of current analysis was restricted to 4768 subjects with true data and deficiency no more than 5％.There were 2252 males and 2516 females.The age range was from 16 to 90 years,a median age 59.0 (50.0-69.0) years,onset age of diabetes 52.0 (44.0-60.0)years ; a range of disease duration from 1 day to 42 years and a median of 5.0 (2.0-11.0) years.The median body mass index was 26.33 (24.88 28.34) kg/m2 and median waist circumference 93.0(88.0-100.0)cm.Median HbA1c was 8.1％ (6.9％-10.1％)and only 26.2％ patients reached the target level of HbA1c ＜7.0％.Influencing factors of poor glycemic control were central obesity,high levels of resting heart rate,concurrent fatty liver and high intensity of treatment.And influencing factors of good glycemic control were regular exercises,smoking cessation,regular glycemic monitoring and good control of total chloestrol/triglyceride.Conclusion A majority of Guangdong type 2 diabetics fail to achieve target values for glycemic control.There is an urgent need for comprehensive management for improving glycemic control.