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

李元昊; 王奕婧; 刘刚

Abstract

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].Chinese journal of Epidemiology,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

Received:May 16, 2024

DOI：10.3760/cma.j.cn112338-20240516-00277

KeyWord: 糖尿病，2型血糖控制影响因素社区

English Key Word: Diabetes mellitus, type 2 Blood glucose control Influencing factors Community

FundProject:深圳市“医疗卫生三名工程”（SZSM202311001）

Author Name	Affiliation	E-mail
Li Yuanhao	The Third People's Hospital of Hubei Province, Wuhan 430000, China
Wang Yijing	Department of Service Management, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China
Liu Gang	Department of Service Management, Shenzhen Center for Disease Control and Prevention, Shenzhen 518055, China	sliugang@163.com

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Abstract:

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。

English Abstract:

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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