Cambra K, Galbete A, Forga L, Lecea O, Ariz M J, Moreno-Iribas C, Aizpuru F, Ibañez B
Navarrabiomed-FMS, C/ Irunlarrea 8, Recinto CHN, 31008, Pamplona, Spain.
Health Services Research on Chronic Patients Network (REDISSEC), Pamplona, Spain.
BMC Fam Pract. 2016 Oct 12;17(1):144. doi: 10.1186/s12875-016-0533-9.
We aimed to determine the degree to which control targets of glycaemia and cardiovascular risk factors were achieved among patients with type 2 diabetes and to investigate sex- and age-related differences in this population.
This cross-sectional, population-based study was conducted in Spain. Glycated hemoglobin (HbA1c), blood pressure, LDL-c, HDL-c, triglycerides, BMI, and smoking history were obtained from electronic clinical primary care records (n = 32,638 cases). The proportions of patients who met control targets were determined according to sex and age groups. Comparisons between groups were conducted with t-tests for continuous variables, tests for trends in proportions for categorical and ordinal variables, and Pearson's chi-square tests and binary logistic regression models for categorical variables.
The overall proportions of patients with type 2 diabetes who met the target objectives for HbA1c (<7 %, 53 mmol/mol), blood pressure (130/80 mmHg), and LDL-cholesterol (100 mg/dl) were 60, 40 and 41 %, respectively. Women were less likely than men to meet the control targets of HbA1c (59 vs 61 %), LDL (35 vs 45 %), and HDL (58 vs 78 %). Patients under 65 years of age presented poorer control than older age groups. Only a minority of patients with type 2 diabetes met the composite target objectives for glycemic control, blood pressure, and LDL.
There are differential gaps in the control results of female patients and younger patients, which should prompt improvements in case management and care. There is room for further improvement in the cardiometabolic control of patients with type 2 diabetes.
我们旨在确定2型糖尿病患者实现血糖及心血管危险因素控制目标的程度，并调查该人群中与性别和年龄相关的差异。
这项基于人群的横断面研究在西班牙开展。从电子临床初级保健记录中获取糖化血红蛋白（HbA1c）、血压、低密度脂蛋白胆固醇（LDL-c）、高密度脂蛋白胆固醇（HDL-c）、甘油三酯、体重指数（BMI）及吸烟史（n = 32,638例）。根据性别和年龄组确定达到控制目标的患者比例。对连续变量采用t检验进行组间比较，对分类和有序变量采用比例趋势检验，对分类变量采用Pearson卡方检验和二元逻辑回归模型。
2型糖尿病患者中达到HbA1c（<7%，53 mmol/mol）、血压（130/80 mmHg）和低密度脂蛋白胆固醇（100 mg/dl）目标的总体比例分别为60%、40%和41%。女性达到HbA1c（59%对61%）、LDL（35%对45%）和HDL（58%对78%）控制目标的可能性低于男性。65岁以下患者的控制情况比老年组差。只有少数2型糖尿病患者达到血糖控制、血压和LDL的综合目标。
女性患者和年轻患者的控制结果存在差异，这应促使病例管理和护理得到改善。2型糖尿病患者的心脏代谢控制仍有进一步改善的空间。
