Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea.
Diabetes Metab J. 2014 Jun;38(3):197-203. doi: 10.4093/dmj.2014.38.3.197. Epub 2014 Jun 17.
The Korea National Health and Nutrition Examination Survey (KNHANES) III (2005) reported that 22.9% of individuals with diabetes have a glycated hemoglobin (HbA1c) <6.5% and that 43.5% have an HbA1c <7%. We investigated the levels of glycemic control and the factors associated with glycemic control using data from the KNHANES V (2010 to 2012).
Subjects with diabetes diagnosed by a physician or those taking antidiabetic medications were classified as individuals with known diabetes. Of 1,498 subjects aged ≥30 years with diabetes, we excluded 157 individuals who were missing HbA1c data. A total of 1,341 subjects were included in the final analysis.
The prevalence of known diabetes was 7.7% (n=1,498, estimated to be 2.32 million people). The proportions of well-controlled diabetes meeting a HbA1c goal of <6.5% and <7% were 27% and 45.6%, respectively. HbA1c increased as the duration of diabetes increased. HbA1c in subjects with a duration of diabetes ≤5 years was lower than in subjects with a duration >5 years. HbA1c in the group taking only oral hypoglycemic agents (OHAs) was significantly lower than that in the group administered only insulin or OHA and insulin in combination. In logistic regression analysis, a longer duration of diabetes, insulin use and the absence of chronic renal failure were associated with HbA1c levels >6.5%.
The level of adequate glycemic control was similar to but slightly improved compared with previous levels. The glycemic control of long-standing diabetes patients is more difficult even though they receive insulin treatment.
韩国国家健康与营养检查调查(KNHANES)III(2005 年)报告称,22.9%的糖尿病患者糖化血红蛋白(HbA1c)<6.5%,43.5%的患者 HbA1c<7%。我们利用 KNHANES V(2010 年至 2012 年)的数据,调查了血糖控制水平和与血糖控制相关的因素。
通过医生诊断或服用抗糖尿病药物的患者被归类为已知糖尿病患者。在 1498 名年龄≥30 岁且患有糖尿病的患者中,我们排除了 157 名 HbA1c 数据缺失的患者。共有 1341 名患者纳入最终分析。
已知糖尿病的患病率为 7.7%(n=1498,估计有 232 万人)。HbA1c 达标(<6.5%和<7%)的糖尿病患者比例分别为 27%和 45.6%。HbA1c 随着糖尿病病程的延长而增加。病程≤5 年的患者的 HbA1c 低于病程>5 年的患者。仅服用口服降糖药(OHA)的患者的 HbA1c 明显低于仅接受胰岛素或 OHA 和胰岛素联合治疗的患者。在逻辑回归分析中,较长的糖尿病病程、使用胰岛素以及没有慢性肾衰竭与 HbA1c>6.5%相关。
适当的血糖控制水平与之前的水平相似,但略有改善。即使接受胰岛素治疗,长期糖尿病患者的血糖控制也更加困难。