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中国2型糖尿病胰岛素治疗患者的血糖控制与自我血糖监测:COMPASS研究的基线结果

Glycemic control and self-monitoring of blood glucose in Chinese patients with type 2 diabetes on insulin: Baseline results from the COMPASS study.

作者信息

Ji L, Su Q, Feng B, Shan Z, Hu R, Xing X, Xue Y

机构信息

Peking University People's Hospital, Beijing, China.

Xin Hua Hospital, Shanghai, China.

出版信息

Diabetes Res Clin Pract. 2016 Feb;112:82-87. doi: 10.1016/j.diabres.2015.08.005. Epub 2016 Jan 13.

Abstract

AIMS

Self monitoring of blood glucose (SMBG) is not widely utilized in insulin-treated patients with type 2 diabetes. In this analysis, we evaluated the current state of SMBG in Chinese adults with type 2 diabetes treated with insulin.

METHODS

The 2-phase COMPASS study involved 24 centers across 10 provinces and cities in China. In the first phase, a cross sectional survey was carried out in type 2 diabetes patients receiving insulin treatment. The inclusion criteria for the study subjects in the first phase were: type 2 diabetes, insulin treatment for ≥ 3 months, and age ≥ 18 years. Evaluation was made on the status of SMBG and insulin therapy in these patients by a questionnaire.

RESULTS

A total of 2819 patients (age 58.2 ± 10.8 years; 49.6% females; BMI 24.6 ± 3.4 kg/m(2)) with insulin-treated type 2 diabetes were recruited in phase I of this study. The majority of patients (80.4%) were receiving insulin treatment for at least 6 months. At baseline, the mean HbA1c was 8.5 ± 1.9% and 54.6% of patients had an HbA1c above 8%. 50.4% of the cohort had diabetes for at least 10 years, and fewer of these patients achieved HbA1c <7.0% (53 mmol/mol). At baseline, 65.8% of patients reported that daily SMBG frequency was performed on a random basis. 59.2% of patients reported that they occasionally, rarely or never follow their physician's instructions regarding SMBG. Hypoglycemia occurred in over 50% of patients, although in 71.8% of patients this was a rare occurrence.

CONCLUSIONS

There is low utilization of SMBG in Chinese adults with insulin-treated type 2 diabetes, with approximately two-thirds of patients reporting irregular use of SMBG. This is in line with an overall poor level of glycemic control.

摘要

目的

自我血糖监测(SMBG)在接受胰岛素治疗的2型糖尿病患者中未得到广泛应用。在本分析中,我们评估了中国接受胰岛素治疗的2型糖尿病成年患者的SMBG现状。

方法

两阶段的COMPASS研究涉及中国10个省市的24个中心。在第一阶段,对接受胰岛素治疗的2型糖尿病患者进行了横断面调查。第一阶段研究对象的纳入标准为:2型糖尿病、胰岛素治疗≥3个月且年龄≥18岁。通过问卷调查对这些患者的SMBG和胰岛素治疗状况进行评估。

结果

本研究第一阶段共招募了2819例接受胰岛素治疗的2型糖尿病患者(年龄58.2±10.8岁;49.6%为女性;体重指数24.6±3.4kg/m²)。大多数患者(80.4%)接受胰岛素治疗至少6个月。基线时,平均糖化血红蛋白(HbA1c)为8.5±1.9%,54.6%的患者HbA1c高于8%。该队列中50.4%的患者患糖尿病至少10年,这些患者中达到HbA1c<7.0%(53 mmol/mol)的较少。基线时,65.8%的患者报告每日SMBG频率是随机进行的。59.2%的患者报告他们偶尔、很少或从不遵循医生关于SMBG的指示。超过50%的患者发生过低血糖,尽管71.8%的患者低血糖发生频率较低。

结论

中国接受胰岛素治疗的2型糖尿病成年患者中SMBG的利用率较低,约三分之二的患者报告SMBG使用不规律。这与血糖控制的总体较差水平一致。

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