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了解血糖控制不达标2型糖尿病患者的状况,促进血糖达标,减少并发症。统计469例血糖控制不达标患者的一般资料、血糖和血脂、并发症及合并症、降糖方案(包括生活方式、药物治疗)、监测及治疗方案调整等情况,分析血糖控制不达标原因。469例患者平均FPG(12.96±4.71)mmol/L,平均Hb A1c(9.07±2.38)%,65岁以下患者Hb A1c高于65岁以上患者。81.9%患者出现至少一种微血管并发症,以DPN、DR最多见,42.0%合并心脑血管疾病、37.3%合并高血压病。能严格控制饮食、合理运动及定期参加糖尿病教育者分别为39.2%、33.3%和10.0%。66.7%患者采用口服降糖药物治疗,24.6%为单一口服药物,以磺脲类为主,12.1%应用不明成分药物或保健品治疗,联合口服药物以磺脲类及双胍类两种联合为主,14.1%存在同类药物不合理联合应用,胰岛素治疗者66.7%应用预混胰岛素2次皮下注射。仅有22.6%患者定期进行血糖监测并调整治疗。结论患者血糖控制差,并发症多,不良生活方式、治疗依从性差、治疗方案不合理、较少监测血糖是患者血糖控制不达标的主要原因。
Understanding of glycemic control does not meet the status of patients with type 2 diabetes to promote blood sugar compliance and reduce complications. Statistical analysis of 469 cases of non-compliance of patients with glycemic control of general information, blood glucose and blood lipids, complications and complications, hypoglycemic regimens (including lifestyle, drug treatment), monitoring and treatment programs to adjust the situation, analysis of blood glucose control causes. The mean FPG of 469 patients was (12.96 ± 4.71) mmol / L, the average Hb A1c was (9.07 ± 2.38)%. The Hb A1c in patients under 65 years old was higher than that in patients over 65 years old. At least one microvascular complication occurred in 81.9% of the patients, with the highest DPN, the most common DR, 42.0% with cardiovascular and cerebrovascular diseases, and 37.3% with hypertension. Can strictly control diet, exercise and regularly participate in diabetes education were 39.2%, 33.3% and 10.0%. 66.7% of the patients were treated with oral hypoglycemic drugs, 24.6% were single oral drugs, mainly sulfonylureas, 12.1% of unknown drugs or supplements, and the combination of oral and topical sulfonylureas and biguanides , 14.1% there is irrational combination of similar drugs, insulin treatment 66.7% premixed insulin subcutaneous injection 2 times. Only 22.6% of patients regularly monitor blood glucose and adjust treatment. Conclusion Patients with poor blood glucose control, multiple complications, poor lifestyles, poor treatment compliance, and unreasonable treatment regimens, and less monitoring of blood glucose are the main reasons for the non-compliance of glycemic control in patients.