Kirizuka K, Nishizaki H, Kohriyama K, Nukata O, Arioka Y, Motobuchi M, Yoshiki K, Tatezumi K, Kondo T, Tsuboi S
Department of Internal Medicine, Kobe West City Hospital, Ichiban-cho, Nagata-Ku, Japan.
Diabetes Res Clin Pract. 1997 Jun;36(3):193-6. doi: 10.1016/s0168-8227(97)00030-2.
We investigated influences on glycemic control in 177 diabetic patients after The Great Hanshin-Awaji Earthquake which occurred on January 17, 1995. Changes in serum HbA(1c) level were studied according to the worsen rate of dietary and living conditions. A significant temporary increase in the mean value of HbA(1c) level was found after the earthquake (8.34 +/- 2.07% in March, 1995 vs. 7.74 +/- 1.82% in December, 1994, P < 0.01). Ninety nine of them showed more than 0.5% in the rate of increase. Multiple regression analysis was applied to the following factors: inappropriate diet, discontinuation of drug uptake, reduction of exercise, destruction of house, long stay at shelter, sex, age, and pre-earthquake therapy. Among them, inappropriate diet demonstrated the highest partial regression coefficient to raise the mean value of the HbA(1c) level. The increased level of HbA(1c) declined gradually to the pre-earthquake level in September, 1995. This study emphasizes the importance of appropriate diet for diabetic patients during a natural disaster. To fulfil it, medical staff have to educate diabetic patients of their disorders tediously in ordinary time. In addition, it seems quite useful to supply a medical information card and a small medical bag containing essential drugs to each patient.
我们调查了1995年1月17日阪神-淡路大地震后177例糖尿病患者血糖控制的影响因素。根据饮食和生活条件的恶化程度研究血清糖化血红蛋白（HbA1c）水平的变化。地震后发现HbA1c水平的平均值有显著的暂时升高（1995年3月为8.34±2.07%，1994年12月为7.74±1.82%，P<0.01）。其中99例患者的升高率超过0.5%。对以下因素进行多元回归分析：饮食不当、停药、运动量减少、房屋毁坏、在避难所长时间停留、性别、年龄和震前治疗。其中，饮食不当对HbA1c水平平均值升高的偏回归系数最高。HbA1c升高水平在1995年9月逐渐降至震前水平。本研究强调了自然灾害期间糖尿病患者合理饮食的重要性。为实现这一点，医务人员必须在平时不厌其烦地对糖尿病患者进行疾病教育。此外，为每位患者提供医疗信息卡和装有基本药物的小药包似乎非常有用。
