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目的以海南省2型糖尿病(T2DM)患者作为主要研究对象,调查T2DM标准化诊疗现状。方法选取2013~2014年在海南省三甲医院门诊就诊及病房住院的T2DM患者2 400例为研究对象,临床医师按照《2010年版中国2型糖尿病防治指南》(简称指南)要求实时收集、录入T2DM诊疗试验数据并进行分析。结果大部分临床医师认为《指南》对临床工作比较有帮助和帮助很大,90%的临床医师通常遵从《指南》。空腹血糖(FPG)成为最常用的T2DM诊断指标,使用率为(6.15±1.01)%;餐后2 h血糖和随机血糖(RBG)使用率分别为(5.36±1.63)%和(4.86±1.71)%。口服降糖药联合生活方式的干预成为最常用的治疗方式,而二甲双胍类成为使用最多的口服降糖药。控制患者糖化血红蛋白(Hb A1c)和FPG水平,并进行综合的调节血脂、降低血压和抗血小板治疗,以有效控制和预防T2DM并发症,促进患者综合达标。结论海南省T2DM标准化诊疗构建已初现成效,有巨大的应用前景,其示范模式可以推广到中国其他省份,以解决全国范围内的T2DM防治问题。
Objective To investigate the status quo of T2DM standardized diagnosis and treatment in patients with type 2 diabetes mellitus (T2DM) in Hainan Province. Methods Totally 2 400 cases of T2DM patients attending outpatient clinics and hospital wards in Hainan Province from 2013 to 2014 were selected as study subjects. Clinicians were recruited in real time according to the requirements of Guideline for Prevention and Treatment of Type 2 Diabetes in 2010 (referred to as Guidelines) Test data and analyze. Results Most clinicians consider the Guide helpful and helpful for clinical work, and 90% of clinicians usually follow the Guideline. The fasting blood glucose (FPG) was the most commonly used diagnostic indicator of T2DM with the rate of (6.15 ± 1.01)%; the postprandial 2 h blood glucose and random glucose (RBG) utilization rates were 5.36 ± 1.63% and 4.86 ± 1.71, respectively %. Oral hypoglycemic agents combined with lifestyle interventions become the most commonly used treatment, and metformin become the most widely used oral hypoglycemic agents. To control the level of Hb A1c and FPG, and to comprehensively regulate blood lipids, reduce blood pressure and anti-platelet therapy to effectively control and prevent T2DM complications and to promote the comprehensive compliance of patients. Conclusions The construction of T2DM standardization diagnosis and treatment in Hainan Province has achieved initial success and has great application prospect. Its demonstration model can be extended to other provinces in China to solve the problem of T2DM prevention and treatment nationwide.