Department of Endocrinology, The Third People's Hospital of Datong, Datong, China.
Department of Cardiology, The Third People's Hospital of Datong, Datong, China.
Medicine (Baltimore). 2021 Oct 29;100(43):e27677. doi: 10.1097/MD.0000000000027677.
This study aimed to clarify of the predictors of poor glycemic control in type 2 diabetes mellitus (T2DM) patients treated with antidiabetic medications in China.This study was a retrospective, cross-sectional study based on SuValue database. T2DM patients aged 18 years or older performing glycosylated hemoglobin A1c (HbA1c) examinations from January 1st, 2018 to December 31st, 2018 were included and have been treated with antidiabetic medications for at least 6 months. HbA1c < 7.0% was defined as adequate glycemic control. Multivariate analysis was performed for the factors associated with poor glycemic control.A total of 13972 T2DM patients were included in this study. The adequate glycemic control rate was 44.04% (n = 6153). In the multivariate analysis, predictors of poor glycemic control include longer T2DM duration (5-10 years vs <5 years and >10 years vs <5 years, odds ratio [OR] = 1.499 and 1.581, P < .001 and P = .008), myocardial infarction (OR = 1.141, P = .041), diabetic neuropathy (OR = 1.409, P < .001), secondary hospital (OR = 1.877, P < .001), underdeveloped regions (OR = 1.786, P < .001), insulin only (OR = 3.912, P < .001), combination of oral antidiabetic agents and/or insulin use (P < .001).In conclusion, longer T2DM duration, secondary hospital, myocardial infarction, diabetic neuropathy, undeveloped regions and use of polypharmacy and insulin were associated with poor glycemic control among T2DM patients treated with antidiabetic medications. Patient education and training of health care providers may be short-term strategy to achieve adequate glycemic control.
本研究旨在阐明中国接受抗糖尿病药物治疗的 2 型糖尿病（T2DM）患者血糖控制不佳的预测因素。本研究基于 SuValue 数据库，是一项回顾性、横断面研究。纳入 2018 年 1 月 1 日至 2018 年 12 月 31 日进行糖化血红蛋白 A1c（HbA1c）检查且至少接受 6 个月抗糖尿病药物治疗的年龄≥18 岁的 T2DM 患者。HbA1c＜7.0%定义为血糖控制良好。对与血糖控制不佳相关的因素进行多变量分析。这项研究共纳入 13972 例 T2DM 患者，血糖控制良好率为 44.04%（n=6153）。多变量分析显示，血糖控制不佳的预测因素包括较长的 T2DM 病程（5-10 年与＜5 年和＞10 年与＜5 年相比，比值比[OR]分别为 1.499 和 1.581，P＜0.001 和 P=0.008）、心肌梗死（OR=1.141，P=0.041）、糖尿病神经病变（OR=1.409，P＜0.001）、二级医院（OR=1.877，P＜0.001）、欠发达地区（OR=1.786，P＜0.001）、仅使用胰岛素（OR=3.912，P＜0.001）、联合使用口服降糖药和/或胰岛素（P＜0.001）。总之，较长的 T2DM 病程、二级医院、心肌梗死、糖尿病神经病变、欠发达地区以及联合使用多种药物和胰岛素与接受抗糖尿病药物治疗的 T2DM 患者血糖控制不佳相关。对患者进行教育和培训医护人员可能是实现血糖控制良好的短期策略。
