Harris M I
National Diabetes Data Group, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland 20892.
Diabetes Care. 1990 Apr;13(4):419-26. doi: 10.2337/diacare.13.4.419.
A national sample of 2879 physicians were surveyed to ascertain characteristics of patient visits for diabetes including whether any test had been ordered or provided or a specimen taken to assess the patient's blood glucose level. Based on survey data, an estimated 21.3 million visits were made for diabetes in 1985. Of these, 16.8 million were for continuing care of diabetes by primary-care physicians, an average of 2.7 visits/yr for the 6.1 million U.S. residents diagnosed as having diabetes. A test for blood glucose was associated with 69% of these visits, an average of 1.9 times/yr per patient with diabetes in the U.S. Rates of testing for blood glucose varied by source of payment for the visit and were higher when diabetes was the primary diagnosis and when the number of physicians practicing together was greater, such as in health maintenance organizations or group practices. Rates of testing did not differ by age, race, or sex of the patient; location of the physician's practice; whether insulin or oral agents were prescribed; or a number of other characteristics. Other studies indicate that self-monitoring of blood glucose is performed by less than 10% of diabetic patients. Hence, the physician's office remains an important location for assessment of diabetes control by measurement of blood glucose levels.
对全国范围内抽取的2879名医生进行了调查，以确定糖尿病患者就诊的特征，包括是否开具或提供了任何检测项目，或者是否采集了标本以评估患者的血糖水平。根据调查数据，1985年估计有2130万人次因糖尿病就诊。其中，1680万人次是由初级保健医生进行的糖尿病持续护理，对于610万被诊断患有糖尿病的美国居民来说，平均每年就诊2.7次。这些就诊中有69%进行了血糖检测，美国糖尿病患者平均每年每人检测1.9次。血糖检测率因就诊支付来源而异，当糖尿病是主要诊断以及在一起执业的医生人数较多时（如在健康维护组织或团体诊所），检测率更高。检测率在患者的年龄、种族或性别、医生执业地点、是否开具胰岛素或口服药物或其他一些特征方面没有差异。其他研究表明，不到10%的糖尿病患者进行自我血糖监测。因此，医生办公室仍然是通过测量血糖水平评估糖尿病控制情况的重要场所。
