RESUMO
BACKGROUND: In China, diabetic patients suffer from various chronic complications with a higher prevalence, which is nearly close to that in developed countries. Especially in Xinjiang, the prevalence is much higher than the average level, and the level of disease control is very poor as a whole.OBJECTIVE: To study the actuality of controlling type 2 diabetes mellitus in Xinjiang so as to analyze its relationship with disease courses.DESIGN: Cluster sampling and stratified analysis.SETTING: Department of Endocrinology, Xinjiang General Hospital of Chinese People's Armed Police Forces.PARTICIPANTS: The survey was conducted at ten treatment centers of Xinjiang(the First Affiliated Hospital of Xinjiang MedicalUniversity, People's Hospital of Xinjiang Uigur Autonomous Region, Urumchi Hospital of Air Force of Chinese PLA, Railway Hospital of Xinjing Uigur Autonomous Region, Military Unit Hospital of Xinjiang, Kuitun Central Hospital of Yili Region of Xinjiang, Kelamay People's Hospital of Xinjiang, Kuler People's Hospital of Xinjiang, the First Division Hospital of Xinjiang Military Unit for Produce and Building, Xinjiang Hospital of Traditional Chinese Medicine). Totally 646 type 2 diabetic patients who had received treatment for diabetes mellitus for 12 months, at any of the centers were randomly recruited with cluster sampling method including 337 males and 309 females. According to different courses of disease, the subjects were divided into 6 groups: 202 cases in group of ＜ 3 years, 89 in group of 3-4 years,89 in group of 5-6 years, 77 in group of 7-9 years, 108 in group of 10-14years, and 81 in group of ≥ 15 years. All the subjects agreed to participate in the survey.METHODS: Patients detected their blood sugar level and urine sugar level themselves with portable diabetograph and test paper. For them, there were at least four days per week to take diabetic diet which was considered as common diet control, and there were at least three days per week to participate in leisure activity and at least half an hour per day to spend in proper exercise which was considered as frequent exercise. Complications of diabetes mellitus were diagnosed with clinical manifestation, disease history and objective examination. The survey was performed through letter,telephone counseling, and patient's reexamination. Enumeration data was analyzed with chi-square test.MAIN OUTCOME MEASURES: Differences in blood sugar, urine sugar, management of living style, prevalence of complications in all the diabetic patients with different courses of disease.RESULTS: There were 645, 645, 643, 646 patients with complete data of blood sugar and urine sugar determined periodically at home, participated in the observation of the management of living style, prevalence of diabetic complications and treatment for diabetes mellitus, respectively. ①There was no significant difference in blood sugar and urine sugar level deter mined at home every month among patients of different courses (P ＞ 0.05). ② There was no difference in diet control and exercise among patients of different courses (P ＞ 0.05). ③In patients with disease course of ＜ 15 years, prevalence of the complication in large vessels and extremity,retinopathy, and positive expression of proteinuria presented an increased tendency; whereas, a decreased tendency was found in patients with the disease course of ≥ 15 years(χ2=34.16,60.64,49.18,P=0.00). ④The proportion of applied therapies, such as diet control and exercise, oral antidiabetic drug, insulin, and insulin plus oral anti-diabetic drug, was different in patients with different disease courses (χ2=97.88 ,P=0.00). In patients with short disease courses, diet control or oral anti-diabetic drug was administrated more usually; in those with long disease courses, insulin treatment or insulin plus oral anti-diabetic drug was applied more frequently.CONCLUSION: ①Whether patients determine their blood sugar and urine sugar levels by themselves is not correlated with patients' disease courses. ②Diet control and exercise are not in correlation with disease courses. ③ For patients with the disease course of less than 15 years, the proportion of prevalence of various diabetic complications is increased with the increase of disease courses; for those with the disease course of more than 15 years, however, it is decreased significantly. ④Simple diet control or oral anti-diabetic drug is often applied in patients with short disease courses while insulin or insulin plus oral anti-diabetic drug are administrated in most patients with long disease courses.