Ji Linong, Newman Julliana, Lu Juming, Cai Xiaoling
Department of Endocrinology and Metabolism, Peking University People's Hospital, Beijing 100044, China. Email:
Research and Development, Bristol-Myers Squibb, Australia.
Chin Med J (Engl). 2014;127(20):3524-9.
Given the pace with which standards of care have changed, timely assessment of their impact on routine clinical practice and patient outcomes is needed. In coordination with the Chinese Diabetes Society (CDS), we developed a quantitative survey to explore the implementation of standards of care for type 2 diabetes (T2D) in China.
A national online survey of physicians involved in the management of T2D in China was conducted over a 4-week period in 2012. Completed responses were obtained from 1 028 physicians. Participants responded to 52 questions designed to capture information relating to their demographic and clinical practice profiles. The questionnaire was divided into three sections: basic information, diagnosis practices and screening methods on main complications, and treatment and control practices. The questionnaire was developed in conjunction with the CDS.
Overall, 83% of surveyed physicians were at least "aware" of the CDS guidelines on standards of care for T2D. Level of awareness was directly related to hospital grade, specialty, geographic location, professional rank and participation in CDS training. The 2-hour oral glucose tolerance test was reported as the most ever-used approach across all three hospital grades and physician specialties, with a usage rate of 97%. Respondents selected their choice of primary treatment for newly diagnosed T2D patients. Just over half (52%) indicated the use of oral anti-diabetic drugs (OAD) monotherapy, in line with CDS recommendations. However, OAD use varied considerably between different regions and city tiers. Despite hemoglobin A1c being defined as the gold standard for glucose control, it was not universally measured, with more physicians indicating routine use of glucose before fasting and glucose non-fasting.
The standards-of-care analysis has provided important insights into the current management of T2D among physicians in China across different geographical regions, hospital grades, specialties, professional statuses, and levels of CDS guideline awareness and training.
鉴于医疗护理标准变化的速度，需要及时评估其对常规临床实践和患者预后的影响。我们与中华医学会糖尿病学分会（CDS）合作，开展了一项定量调查，以探索2型糖尿病（T2D）护理标准在中国的实施情况。
2012年，我们对参与中国T2D管理的医生进行了为期4周的全国在线调查。共收到1028名医生的完整回复。参与者回答了52个问题，这些问题旨在获取有关他们的人口统计学和临床实践概况的信息。问卷分为三个部分：基本信息、主要并发症的诊断实践和筛查方法，以及治疗和控制实践。该问卷是与CDS联合制定的。
总体而言，83%的受访医生至少“知晓”CDS关于T2D护理标准的指南。知晓程度与医院等级、专业、地理位置、专业职称以及参与CDS培训直接相关。在所有三个医院等级和医生专业中，2小时口服葡萄糖耐量试验被报告为使用最多的方法，使用率为97%。受访者选择了他们对新诊断T2D患者的首选治疗方法。略超过一半（52%）的人表示使用口服降糖药（OAD）单药治疗，这与CDS的建议一致。然而，不同地区和城市层级的OAD使用情况差异很大。尽管糖化血红蛋白被定义为血糖控制的金标准，但并非普遍进行测量，更多医生表示常规测量空腹血糖和非空腹血糖。
护理标准分析为了解中国不同地理区域、医院等级、专业、职业地位以及CDS指南知晓和培训水平的医生对T2D的当前管理提供了重要见解。
