Department of Endocrinology, Beijing Jishuitan Hospital, Beijing, China.
Department of Clinical Diabetes and Epidemiology, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia.
J Diabetes Investig. 2020 Nov;11(6):1575-1582. doi: 10.1111/jdi.13282. Epub 2020 May 30.
AIMS/INTRODUCTION: Glycemic control in type 1 diabetes can be challenging, and is influenced by many factors. This study aimed to investigate glycemic control and its associated factors in Chinese people with type 1 diabetes.
This cross-sectional study included 779 participants with type 1 diabetes selected from hospital records review, outpatient clinics and inpatient wards. Data were collected through face-to-face interviews, medical records and venous blood samples. Multiple logistic regression analysis was carried out to determine factors associated with glycemic control.
Among 779 participants, 49.2% were male. The median age was 24 years (interquartile range 14-36 years). The median age at diagnosis of diabetes was 17 years (interquartile range 10-28 years) and the median duration of diabetes was 4 years (interquartile range 1-8 years). The mean ± standard deviation hemoglobin A1c was 9.1 ± 2.5%. Nearly 80% of participants had inadequate glycemic control (hemoglobin A1c ≥7.0%). Multivariable analysis showed that age at diagnosis of diabetes ≤20 years, living in a rural location, low household income, low intake of fruit and vegetables, low level of physical activity, low adherence to insulin, and low utilization of insulin pump were independent risk factors for poor glycemic control (hemoglobin A1c ≥9.0%).
Inadequate glycaemic control is common among people with type 1 diabetes in China. Efforts should be made to control the modifiable risk factors, which include low intake of fruit and vegetables, low level of physical activity, and low adherence to insulin for the improvement of glycemic control. Appropriate use of insulin pump among type 1 diabetes should be encouraged.
目的/引言：1 型糖尿病患者的血糖控制具有挑战性，受多种因素影响。本研究旨在调查中国 1 型糖尿病患者的血糖控制情况及其相关因素。
本横断面研究纳入了 779 名 1 型糖尿病患者，他们是从医院病历回顾、门诊和住院病房中选择的。通过面对面访谈、病历和静脉血样收集数据。采用多因素 logistic 回归分析确定与血糖控制相关的因素。
在 779 名参与者中，49.2%为男性。中位年龄为 24 岁（四分位距 14-36 岁）。糖尿病诊断时的中位年龄为 17 岁（四分位距 10-28 岁），糖尿病病程的中位时间为 4 年（四分位距 1-8 年）。平均±标准差糖化血红蛋白为 9.1±2.5%。近 80%的参与者血糖控制不理想（糖化血红蛋白≥7.0%）。多变量分析显示，糖尿病诊断年龄≤20 岁、居住在农村地区、家庭收入低、水果和蔬菜摄入量低、体力活动水平低、胰岛素依从性低以及胰岛素泵使用率低是血糖控制不佳（糖化血红蛋白≥9.0%）的独立危险因素。
中国 1 型糖尿病患者血糖控制不理想的情况较为常见。应努力控制可改变的危险因素，包括水果和蔬菜摄入量低、体力活动水平低以及胰岛素依从性低，以改善血糖控制。应鼓励 1 型糖尿病患者适当使用胰岛素泵。
