Oskarsdóttir Margrét Dís, Gunnarsson Ragnar
Department of Medicine, University of Iceland, 101 Reykjavík, Iceland.
Laeknabladid. 2006 Jun;92(6):453-7.
Diabetes mellitus type 2 is a common and serious health problem (1). Long term complications reduce quality of life and even life expectancy as well as increasing greatly the cost of health care (1). Complications include macrovascular changes ,coronary heart disease and stroke and also microvascular changes such as ophthalmological, renal and neural damage. With effective control of blood glucose levels and blood pressure for instance, the probability of these complications can be diminished (2). Increased knowledge, new drugs and the publication of clinical guidelines raise the question whether this improves the level of care for diabetics in this rural Health-care Center.
This is a retrospective objective research spanning the years 1999-2003. Data was collected from the journals of 60 patients chosen randomly from the 130 patients diagnosed with diabetes mellitus type 2 during the same period of time. The available data from electrocardiograms, ophthalmologic-, foot and neural examinations, blood pressure measurements, body mass indexes and weight, were all recorded, along with the year of data collection. Also, all the blood tests research data mentioned in the Icelandic Diabetic type 2 Clinical Guidelines were recorded (4).
The average age of persons in the sample was 69 +/- 11.5 years. Males were in a slight majority (59%) and the average weight was 96 +/- 21 kg amongst the 76% who were weighed during the period of investigation. The long term blood glucose mean value, HbA1c, dropped significantly from 7.46 +/- 1.2% at the onset of the period, to 6.53 +/- 0.7% at the termination of the period (p<0.01). Blood pressure dropped from 154 +/- 17,5 and 83 +/- 10,8 mmHg in the year 1999, to 138 +/- 18,1 and 80 +/- 8.4 mmHg during the year 2003 (p<0.01). In the year 1999 the total cholesterol was 5,7 +/- 0,7 mmol/l but in the year 2003 it was 4,7 +/- 0,9 mmol/l (p<0.01). The percentage of patients reaching the established goal increased during the period of investigation (HbA1C; 50 vs 88%, blood pressure; 17 vs 76% and 39 vs 88%, cholesterol; 35 vs 71 %)(p<0.01). There were few significant alterations in the frequency of performed measurements.
During the period of investigation there was an improvement in mean values and most reached the goal of clinical guidelines in the latter period of the investigation.
2型糖尿病是一个常见且严重的健康问题（1）。长期并发症会降低生活质量，甚至缩短预期寿命，同时大幅增加医疗保健成本（1）。并发症包括大血管病变、冠心病和中风，以及微血管病变，如眼科、肾脏和神经损伤。例如，通过有效控制血糖水平和血压，这些并发症的发生概率可以降低（2）。知识的增加、新药的出现以及临床指南的发布，引发了这样一个问题：这是否改善了该农村医疗中心对糖尿病患者的护理水平。
这是一项涵盖1999年至2003年的回顾性客观研究。数据收集自同期被诊断为2型糖尿病的130名患者中随机选取的60名患者的病历。记录了心电图、眼科、足部和神经检查、血压测量、体重指数和体重等可用数据，以及数据收集年份。此外，还记录了冰岛2型糖尿病临床指南中提及的所有血液检测研究数据（4）。
样本中患者的平均年龄为69±11.5岁。男性略占多数（59%），在调查期间称重的76%的患者中，平均体重为96±21千克。长期血糖平均值HbA1c从该时期开始时的7.46±1.2%显著降至该时期结束时的6.53±0.7%（p<0.01）。血压从1999年的154±17.5和83±10.8毫米汞柱降至2003年的138±18.1和80±8.4毫米汞柱（p<0.01）。1999年总胆固醇为5.7±0.7毫摩尔/升，2003年为4.7±0.9毫摩尔/升（p<0.01）。在调查期间，达到既定目标的患者百分比有所增加（HbA1C；50%对88%，血压；17%对76%和39%对88%，胆固醇；35%对71%）（p<0.01）。所进行测量的频率几乎没有显著变化。
在调查期间，平均值有所改善，并且在调查后期大多数患者达到了临床指南的目标。
