Menon A S, Ahluwalia A I
Senior Advisor (Medicine & Endocrinology), Command Hospital (Central Command), Lucknow 226002, India.
Senior Advisor (Medicine & Endocrinology), Base Hospital, Delhi Cantt, India.
Med J Armed Forces India. 2015 Apr;71(2):132-4. doi: 10.1016/j.mjafi.2014.10.008. Epub 2015 Jan 12.
To study the number of patients with Type 2 Diabetes Mellitus who achieve the glycemic, blood pressure and LDL-Cholesterol targets as per American Diabetes Association, Standard of Care for Management of Diabetes.
Hundred patients of Type 2 Diabetes mellitus were recruited from December 2008 to January 2009 from an Endocrinology OPD of tertiary care hospital and followed up for six months. Glycosylated hemoglobin (HbA1c), blood pressure (BP) and LDL-Cholesterol (LDL) were estimated at baseline and prevalence of those at target (HbA1c <7%, BP < 130/80 mm Hg, LDL < 100 mg/dl) was documented and repeated at three and six months to monitor improvement in the number of patients at target and trend in improvement of individual parameters.
The percentage of patients at target at baseline and six months for HbA1c was (45% vs. 55% p = 0.101), BP < 130/80 mm Hg (27% vs. 25%) and LDL <100 mg/dl (37% vs. 40% p = 0.386). All three parameters were at target in one patient and three patients at six months period. Mean values at baseline and six months of HbA1c 7.46% (95% CI 7.17-7.75) vs 7.21% (95% CI 6.9-7.52), Systolic BP 138 mm Hg (95% CI 135-141), Diastolic BP 86 mm Hg (95% CI 84-86) and LDL 114 mg/dl (95%CI 107-121) vs. 110 mg/dl (95%CI 105-116) did not show significant improvement (p for trend).
Standards of care for HbA1c, blood pressure and LDL remains to be achieved in majority of the diabetic patients.
研究根据美国糖尿病协会糖尿病管理护理标准，达到血糖、血压和低密度脂蛋白胆固醇目标的2型糖尿病患者数量。
2008年12月至2009年1月，从一家三级护理医院的内分泌科门诊招募了100名2型糖尿病患者，并随访6个月。在基线时估计糖化血红蛋白（HbA1c）、血压（BP）和低密度脂蛋白胆固醇（LDL），记录达到目标值（HbA1c<7%，BP<130/80 mmHg，LDL<100 mg/dl）的患者比例，并在3个月和6个月时重复测量，以监测达到目标的患者数量的改善情况以及各个参数的改善趋势。
HbA1c在基线和6个月时达到目标的患者百分比分别为（45%对55%，p=0.101），BP<130/80 mmHg（27%对25%），LDL<100 mg/dl（37%对40%，p=0.386）。在6个月期间，有1名患者和3名患者的所有三个参数均达到目标。HbA1c在基线和6个月时的平均值分别为7.46%（95%CI 7.17-7.75）对7.21%（95%CI 6.9-7.52），收缩压138 mmHg（95%CI 135-141），舒张压86 mmHg（95%CI 84-86），LDL 114 mg/dl（95%CI 107-121）对110 mg/dl（95%CI 105-116），未显示出显著改善（趋势p值）。
大多数糖尿病患者的HbA1c、血压和LDL护理标准仍有待实现。
