| 李元昊,王奕婧,刘刚.深圳市社区18~64岁2型糖尿病患者血糖控制情况及影响因素分析[J].中华流行病学杂志,2024,45(10):1419-1425 |
| 深圳市社区18~64岁2型糖尿病患者血糖控制情况及影响因素分析 |
| Analysis of blood glucose control and influencing factors in 18-64 year-old community people with type 2 diabetes in Shenzhen |
| 收稿日期:2024-05-16 出版日期:2024-10-22 |
| DOI：10.3760/cma.j.cn112338-20240516-00277 |
| 中文关键词: 糖尿病，2型 血糖控制 影响因素 社区 |
| 英文关键词: Diabetes mellitus, type 2 Blood glucose control Influencing factors Community |
| 基金项目:深圳市“医疗卫生三名工程”（SZSM202311001） |
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| 中文摘要: |
| 目的 描述深圳市社区18~64岁2型糖尿病患者血糖控制现状并分析其影响因素，为增强社区健康服务机构2型糖尿病管理效果提供参考依据。方法 资料来源于深圳市社区健康服务信息系统。采用横断面调查设计，纳入2022年深圳市社区健康服务机构纳入的18~64岁2型糖尿病患者为研究对象。通过信息系统记录的2022年体检数据计算血糖控制率，并使用多因素logistic回归模型分析血糖控制的影响因素。结果 共纳入研究对象120 174名。血糖控制率为53.04%。多因素logistic回归分析结果显示，女性（OR=1.07，95%CI：1.04~1.10）、年龄45~54岁（OR=1.10，95%CI：1.01~1.19）、55~64岁（OR=1.24，95%CI：1.14~1.35）、文化程度为初中（OR=1.09，95%CI：1.05~1.13）、高中/中专（OR=1.26，95%CI：1.21~1.31）、大专及以上（OR=1.75，95%CI：1.67~1.83）、城镇职工基本医疗保险（OR=1.05，95%CI：1.01~1.08）、每周运动（OR=1.26，95%CI：1.22~1.31）、每天运动（OR=1.31，95%CI：1.28~1.35）及合并高血压（OR=1.21，95%CI：1.18~1.24）患者血糖控制达标的可能性较高；未婚（OR=0.85，95%CI：0.77~0.95）、离异（OR=0.84，95%CI：0.73~0.97）、保险情况为全自费（OR=0.95，95%CI：0.91~0.99）、糖尿病病程为5~年（OR=0.65，95%CI：0.63~0.66）、糖尿病病程≥10年（OR=0.41，95%CI：0.39~0.42）、有糖尿病药物治疗（OR=0.74，95%CI：0.71~0.76）、低体重（OR=0.89，95%CI：0.80~1.00）、肥胖（OR=0.85，95%CI：0.82~0.88）、合并中心性肥胖（OR=0.83，95%CI：0.81~0.86）、合并血脂异常（OR=0.69，95%CI：0.68~0.71）、现在吸烟（OR=0.74，95%CI：0.72~0.77）、现在饮酒（OR=0.97，95%CI：0.93~1.00）患者血糖控制达标的可能性较低。结论 深圳市社区18~64岁2型糖尿病患者的血糖控制率仍有一定的提升空间。应进一步加强对18~64岁2型糖尿病患者的重视程度，特别是对血脂异常、中心性肥胖和糖尿病病程较长的患者，加强对吸烟、饮酒和缺乏运动等不良习惯患者的监督和指导。 |
| 英文摘要: |
| Objective To describe the current situation of blood glucose control in 18-64 year-old people with type 2 diabetes in the Shenzhen community and analyze the influencing factors to provide a reference for enhancing the management effect of type 2 diabetes in community health service institutions. Methods The data were from the Shenzhen Community Health Service Information System. A cross-sectional survey design was adopted to include 18-64 year-old patients with type 2 diabetes in Shenzhen community health service institutions in 2022. The blood glucose control rate was calculated through the physical examination data recorded by the information system in 2022, and the influencing factors of blood glucose control in this group of patients were analyzed using a multivariate logistic regression model. Results A total of 120 174 patients were included in the study. The blood glucose control rate was 53.04%. The results of multivariate logistic regression analysis showed that women (OR=1.07, 95%CI: 1.04-1.10), ages 45-54 (OR=1.10, 95%CI: 1.01-1.19), 55-64 (OR=1.24, 95%CI: 1.14-1.35), middle school (OR=1.09, 95%CI: 1.05-1.13), high school and technical secondary school (OR=1.26, 95%CI: 1.21-1.31), junior college or above (OR=1.75, 95%CI: 1.67-1.83), basic medical insurance for urban employees (OR=1.05, 95%CI: 1.01-1.08), weekly exercise (OR=1.26, 95%CI: 1.22-1.31), daily exercise (OR=1.31, 95%CI: 1.28-1.35) and combined hypertension (OR=1.21, 95%CI: 1.18-1.24) were more likely to reach the standard of blood glucose control; while unmarried (OR=0.85, 95%CI: 0.77-0.95), divorced (OR=0.84, 95%CI: 0.73-0.97), insurance status was fully self-funded (OR=0.95, 95%CI: 0.91-0.99), disease duration was 5- years (OR=0.65, 95%CI: 0.63-0.66), ≥10 years (OR=0.41, 95%CI: 0.39-0.42), the treatment method was diabetes drug therapy (OR=0.74, 95%CI: 0.71-0.76), low weight (OR=0.89, 95%CI: 0.80-1.00), obese group (OR=0.85, 95%CI: 0.82-0.88), combined with central obesity (OR=0.83, 95%CI: 0.81-0.86), combined with dyslipidemia (OR=0.69, 95%CI: 0.68-0.71), current smoking (OR=0.74, 95%CI: 0.72-0.77), and current drinking (OR=0.97, 95%CI: 0.93-1.00) were less likely to reach the standard of blood glucose control. Conclusions The blood glucose control rate of 18-64 year-old people with type 2 diabetes in Shenzhen still has room for improvement. More attention should be paid to 18-64 year-old patients with type 2 diabetes, especially for patients with dyslipidemia, central obesity, and diabetes with a long course, and supervision and guidance should be strengthened for patients with bad habits such as smoking, drinking alcohol, and lack of exercise. |
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