摘要
目的了解社区2型糖尿病(T2DM)患者的经济水平与其血糖控制的关系,为北京市社区T2DM患者纵向管理制定个体化的方案提供科学依据。方法2008年8月—2009年7月,我院与北京市多个社区卫生服务中心联合开展T2DM纵向管理项目。采用多级抽样的方法,纳入北京市5个城区中15个社区卫生服务中心,共2887例T2DM患者自愿参加本次调查。全体参与医师经过专门培训,按统一要求调查并填写调查表,同时对患者进行体格检查及相关的实验室检查。结果(1)不同经济水平的T2DM患者,其性别、年龄、教育程度、吸烟等指标间差异有统计学意义(P<0.05)。(2)不同经济水平的患者,其糖尿病病程、体质指数、腰围、舒张压、空腹血糖、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平间差异有统计学意义(P<0.05)。(3)按血糖水平7.0mmol/L为标准,将血糖控制情况分为良好(血糖≤7.0mmol/L)和差(血糖>7.0mmol/L),经济水平由低到高4组患者的血糖控制良好率分别为40.68%、42.31%、49.69和48.05%;其中人均月收入为2000～元的患者血糖控制最佳,与<1000元/月的患者比较,差异有统计学意义(P=0.005)。(4)调整年龄、糖尿病病程、肥胖、LDL-C等相关因素后Logistic回归分析表明,经济水平对血糖控制仍呈独立相关性,人均月收入>1000元的患者,其血糖水平>7.0mmol/L的风险是<1000元/月的患者的0.868倍〔OR95%CI(0.778,0.968)〕;人均月收入在1000～元、2000～元、4000～元的患者,其血糖>7.0mmol/L的风险是<1000元/月的患者的0.992倍〔OR95%CI(0.754,1.306)〕、0.778倍〔OR95%CI(0.585,1.035)〕和0.775倍〔OR95%CI(0.508,1.181)〕。结论T2DM患者经济水平影响血糖控制,经济水平高的患者血糖水平控制得好,其中收入为2000～3999元/月的患者血糖控制最佳。
Objective To investigate economic status and blood glucose （BG） control of type 2 diabetes mellitus （T2DM） in 15 communities of Beijing. Methods A total of 2887 T2DM patients were enrolled by multi - stage sampling method in this study in 15 communities. All physicians involved were specially trained and filled in the questionnaire according to uniform requirements. The patients received physical examinations and relevant laboratory tests. Results There was significant differ- ence in gender, age, educational level, smoking, and duration of diabetes, body mass index, waist circumference, diastolic blood pressure, and the levels of fasting glucose, high - density lipoprotein cholesterol, low - density lipoprotein cholesterol be- tween T2DM patients in difference economic levels （ P 〈 0.05 ）. Taking 7. 0 mmoL/L as standard BG level and dividing BG con- trol into ＂ good＂ （ ≤7.0 nunol/L） and ＂ bad＂ （ 〉7.0 retool/L） , the good BG control of 4 groups in different economic levels （from low to high） were 40. 68% , 42. 31% , 49. 69, 48.05% , respectively, and the glucose level was significantly lower in the group whose income was over 2000 - 4 000 ￥/M than in group whose income below 1 000 ￥/M （ P = 0. 005 ）. After adjust- ment of such factors as age, duration of diabetes, obesity and LDL - C, Logistic multi - regression analysis showed that economic level was independently correlated with BG control, that the BG risk （ 〉 7.0 mmol/L） of patients with over 1000 ￥/M income was 0. 868 times that of those with below 1000 ￥/M [ OR 95% CI （0. 778, 0. 968） 3, and that of those with 1000 - 2 000, 2000-4000, 4000〉 ￥/M income was 0.992 [OR95%CI （0.754, 1.306）3, 0.778 [OR95%CI （0.585, 1.035）3, 0. 775 [ OR 95% CI （0. 508, 1. 181 ） ] times that of those with below 1000 ￥/M income. Conclusion The economic level is of effect on BG control, patients with better income control better, and those with 2000 -3 999 ￥/M income control best.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第2期128-132,共5页
Chinese General Practice
基金
首都医学发展科研基金(2007-1035)
关键词
糖尿病
2型
社区卫生服务
社会经济因素
血糖
Diabetes mellitus, type 2
Community health services
Socioeconomic factors
Blood glucose
