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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 understand the relationship between the economic level of patients with type 2 diabetes mellitus (T2DM) and their glycemic control in community and to provide a scientific basis for establishing individualized plans for longitudinal management of T2DM patients in Beijing community. Methods From August 2008 to July 2009, our hospital and a number of community health service centers in Beijing jointly conducted the T2DM longitudinal management project. A total of 2887 T2DM patients participated voluntarily in this survey by adopting multistage sampling method and included in 15 community health service centers in 5 urban districts of Beijing. All participating physicians through specialized training, according to uniform requirements of the survey and fill out the questionnaire, at the same time the patient physical examination and related laboratory tests. Results (1) There were significant differences in gender, age, educational attainment and smoking between T2DM patients with different economic levels (P <0.05). (2) There were significant differences in diabetes course, body mass index, waist circumference, diastolic blood pressure, fasting blood glucose, high density lipoprotein cholesterol, and low density lipoprotein cholesterol among different economic levels (P <0.05). (3) According to the blood glucose level of 7.0mmol / L as the standard, the glycemic control was divided into good (blood glucose ≤7.0mmol / L) and poor (blood glucose> 7.0mmol / L), economic level from low to high in four groups The rate of good control was 40.68%, 42.31%, 49.69 and 48.05% respectively. Among them, the per capita monthly income of patients with 2000 ~ 2000 yuan was the best, with the difference being statistically significant (P = 0.005 ). (4) Logistic regression analysis of related factors such as age, duration of diabetes, obesity, and LDL-C showed that the economic level remained independent of glycemic control, with a blood glucose level> 7.0mmol / The risk of L was 0.868 times (OR 95% CI 0.778,0.968) in patients who were less than 1000 yuan / month. The patients whose per capita monthly income was between 1000 yuan, 2000 yuan and 4000 yuan had a blood glucose> 7.0mmol / L (OR 95% CI 0.754,1.306), 0.778-fold [OR 95% CI (0.585,1.035)] and 0.775-fold OR 95% CI (0.508,1.181) for patients <1000 yuan / month. Conclusion The economic level of patients with T2DM affects the control of blood glucose, and the patients with high economic level control the blood sugar level well. The patients with income of 2000-3999 yuan / month have the best blood sugar control.