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目的了解社区2型糖尿病(T2DM)患者血糖、血压以及血脂控制情况,为开展健康教育和行为干预提供依据。方法将宁波市江北区慈城镇根据地理位置划分为5个片区,采用随机数字表法,从每个片区的社区全科医生集成业务平台中各抽取T2DM患者40例,开展问卷调查、体格检查、血糖和生化检测。采用多因素Logistic回归模型分析血糖、血压和血脂控制达标的影响因素。结果实际完成调查199例,应答率为99.50%,血糖、血压和血脂控制的达标率分别为23.12%、15.58%和31.66%,三项均达标者占0.50%。多因素Logistic回归分析显示,血糖达标与患者年龄相关(OR=0.621,95%CI:0.393~0.981);血压达标与患者签约家庭医生相关(OR=0.393,95%CI:0.177~0.872);血脂达标与男性(OR=0.461,95%CI:0.247~0.863)、无中心性肥胖(OR=0.384,95%CI:0.205~0.719)相关。结论江北区社区T2DM患者血糖、血压和血脂控制达标率不够理想。血糖控制应关注年龄偏小者,血脂控制应关注女性和中心性肥胖者,建议将糖尿病患者的自我管理和家庭医生的个体化管理有效结合。
Objective To understand the control of blood glucose, blood pressure and blood lipid in community-type 2 diabetes mellitus (T2DM) patients and provide the basis for health education and behavior intervention. Methods Cicheng Town, Jiangbei District, Ningbo City was divided into five areas according to its geographical location. Random number table method was used to select 40 T2DM patients from community integrated service platform in each area. Questionnaires, physical examination, Blood glucose and biochemical tests. Multivariate Logistic regression model was used to analyze the influencing factors of glycemic control, blood pressure and lipid control. Results The actual completion of the survey of 199 cases, the response rate was 99.50%, blood glucose, blood pressure and blood lipid control compliance rates were 23.12%, 15.58% and 31.66%, respectively, three of the targets were 0.50%. Multivariate logistic regression analysis showed that the blood glucose level was related to patient’s age (OR = 0.621, 95% CI: 0.393-0.981); blood pressure reached the standard of family doctor (OR = 0.393, 95% CI: 0.177-0.872) Compliance was associated with males (OR = 0.461, 95% CI: 0.247-0.863) and no central obesity (OR = 0.384, 95% CI: 0.205-0.719). Conclusion The T2DM patients in community of Jiangbei District have not achieved satisfactory rate of glycemic control, blood pressure and lipid control. Blood sugar control should focus on those who are young, lipids control should focus on women and central obesity, it is recommended that patients with diabetes self-management and family doctor’s effective integration of individual management.