Department of Family Medicine, University of Tartu, Estonia.
Eur J Gen Pract. 2010 Jun;16(2):85-91. doi: 10.3109/13814788.2010.481017.
To assess glycaemic control among Estonian patients with type 2 diabetes mellitus (DM2) and to find patient and disease related factors associated with adequate glycaemic control.
A cross-sectional study of 200 randomly selected DM2 patients from a primary care setting. Data on each patient's glycosylated haemoglobin (HbA1c), body mass index, blood pressure, and medications for treatment of DM2 were provided by family doctors. A structured patient questionnaire was administered as a telephone interview (n = 166). The patients' self-management behaviour, awareness of the HbA1c test and its recent value were inquired.
The mean HbA1c of the DM2 patients was 7.5%. The targets of DM2 treatment were achieved as follows: 39% of the patients had HbA1c below 6.5% and half the patients had HbA1c below 7%. More than third of the patients had systolic blood pressure below 140 mmHg and in 51% of the patients diastolic blood pressure was below 85 mmHg. Six per cent of the patients were in normal weight (<25 kg/m(2)). Fifty-two per cent of the patients were aware of the HbA1c test and 36% of them knew its recent value. In multivariate regression analysis, awareness of the HbA1c test but not the HbA1c value, longer duration of diabetes and not having a self-monitoring device were independently associated with adequate glycaemic control (HbA1c< 6.5%).
The studied DM2 patients often did not reach the clinical targets suggested in the guidelines. Awareness of the HbA1c test was related to better glycaemic control. However, advanced stage of the disease had a negative effect on HbA1c.
评估爱沙尼亚 2 型糖尿病（DM2）患者的血糖控制情况，并找出与血糖控制达标相关的患者和疾病相关因素。
这是一项在初级保健环境中随机选择 200 名 DM2 患者的横断面研究。家庭医生提供了每位患者的糖化血红蛋白（HbA1c）、体重指数、血压和治疗 DM2 的药物数据。通过电话访谈（n = 166）对患者进行了结构化的患者问卷调查。询问了患者的自我管理行为、对 HbA1c 检测及其最近值的认识。
DM2 患者的平均 HbA1c 为 7.5%。DM2 治疗的目标如下：39%的患者 HbA1c 低于 6.5%，一半的患者 HbA1c 低于 7%。超过三分之一的患者收缩压低于 140mmHg，51%的患者舒张压低于 85mmHg。6%的患者体重正常（<25kg/m2）。52%的患者了解 HbA1c 检测，36%的患者了解其最近的检测值。多变量回归分析显示，知晓 HbA1c 检测但不知晓 HbA1c 值、糖尿病病程较长以及没有自我监测设备与血糖控制达标（HbA1c<6.5%）独立相关。
研究中的 DM2 患者通常未达到指南中建议的临床目标。对 HbA1c 检测的知晓与更好的血糖控制相关。然而，疾病的晚期对 HbA1c 有负面影响。
