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13970名接受药物治疗的中国2型糖尿病女性血糖控制不佳的非药物因素:中国四个城市77家三级医院的横断面调查

Non-pharmaceutical factors for poor glycemic control in 13,970 Chinese women with drug-treated type 2 diabetes: a cross-sectional survey in 77 tertiary hospitals in four Chinese cities.

作者信息

Lu Juming, Weng Jianping, Gu Weijun, Guo Xiaohui, Yang Wenying, Zou Dajin, Zhou Zhiguang, Zhu Dalong, Ji Qiuhe, Ji Linong, Yang Xilin

机构信息

Department of Endocrinology, Chinese PLA General Hospital, Beijing, People's Republic of China.

Department of Endocrinology, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China.

出版信息

Patient Prefer Adherence. 2014 Aug 30;8:1161-7. doi: 10.2147/PPA.S66915. eCollection 2014.

Abstract

BACKGROUND

Achieving good glycemic control improves clinical outcomes among patients with type 2 diabetes (T2D). This study aimed to explore non-pharmaceutical factors for poor glycemic control in Chinese women with T2D who used antidiabetic drug(s).

METHODS

A cross-sectional survey was conducted in March to June 2011 in 77 top tertiary hospitals in Beijing, Shanghai, Tianjin, and Guangzhou, People's Republic of China (the coverage rates of the 3A hospitals: 74.4%, 76%, 55%, and 29.3%, respectively). Of 29,502 patients with T2D who used oral antidiabetic drugs (OADs) alone or combined with insulin, 13,970 were women and used in the analysis. Logistic regression analysis was used to obtain odds ratios (ORs) and 95% confidence intervals (CIs) of factors for hyperglycemia defined as HbA1c (glycated hemoglobin) ≥77 mmol/mol (7.0%).

RESULTS

The mean age was 60.3 (standard deviation 11.0) years, with a median of 4 (interquartile range 2-9) years of duration of diabetes, and 65.1% had hyperglycemia. In multivariable analysis, body height of ≥164 cm (OR 1.26, 95% CI 1.15-1.37) and obesity (OR 1.16, 95% CI 1.04-1.31) was associated with increased risk of hyperglycemia, while self-monitoring blood glucose (SMBG) decreased the risk of hyperglycemia (OR 0.78, 95% CI 0.73-0.84). Duration of diabetes ≥3 years (≥3 to <6 years, OR 1.46, 95% CI 1.32-1.62; ≥6 to <10 years, OR 1.65, 95% CI 1.44-1.89), especially ≥10 years (OR 1.95, 95% CI 1.73-2.19), was associated with higher risks of hyperglycemia.

CONCLUSION

Body height ≥164 cm, obesity, and duration of diabetes ≥3 years increased while SMBG decreased risk of hyperglycemia in Chinese women with OAD-treated T2D.

摘要

背景

实现良好的血糖控制可改善2型糖尿病(T2D)患者的临床结局。本研究旨在探讨使用抗糖尿病药物的中国T2D女性血糖控制不佳的非药物因素。

方法

2011年3月至6月在中国北京、上海、天津和广州的77家顶级三级医院进行了一项横断面调查(3A医院的覆盖率分别为74.4%、76%、55%和29.3%)。在29502例单独使用口服抗糖尿病药物(OADs)或联合胰岛素的T2D患者中,13970例为女性并纳入分析。采用逻辑回归分析获得定义为糖化血红蛋白(HbA1c)≥77 mmol/mol(7.0%)的高血糖因素的比值比(OR)和95%置信区间(CI)。

结果

平均年龄为60.3(标准差11.0)岁,糖尿病病程中位数为4(四分位间距2 - 9)年,65.1%的患者患有高血糖。在多变量分析中,身高≥164 cm(OR 1.26,95% CI 1.15 - 1.37)和肥胖(OR 1.16,95% CI 1.04 - 1.31)与高血糖风险增加相关,而自我血糖监测(SMBG)降低了高血糖风险(OR 0.78,95% CI 0.73 - 0.84)。糖尿病病程≥3年(3至<6年,OR 1.46,95% CI 1.32 - 1.62;6至<10年,OR 1.65,95% CI 1.44 - 1.89),尤其是≥10年(OR 1.95,95% CI 1.73 - 2.19)与更高的高血糖风险相关。

结论

在使用OAD治疗的中国T2D女性中,身高≥164 cm、肥胖和糖尿病病程≥3年增加了高血糖风险,而SMBG降低了高血糖风险。

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本文引用的文献

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Standards of medical care in diabetes--2013.《糖尿病医疗护理标准——2013》
Diabetes Care. 2013 Jan;36 Suppl 1(Suppl 1):S11-66. doi: 10.2337/dc13-S011.
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The effort required to achieve and maintain optimal glycemic control.实现和维持最佳血糖控制所需的努力。
J Diabetes Complications. 2011 Sep-Oct;25(5):283-8. doi: 10.1016/j.jdiacomp.2011.01.002. Epub 2011 Mar 1.
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A summary of the ADVANCE Trial.ADVANCE试验总结。
Diabetes Care. 2009 Nov;32 Suppl 2(Suppl 2):S357-61. doi: 10.2337/dc09-S339.

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