The control status of glycosylated hemoglobin and its influencing factors in the middle aged and elderly patients with type 2 diabetes mellitus in Lanzhou communities / 中国医师进修杂志

ABSTRACT

Objective To investigate the control status of glycosylated hemoglobin (HbA1c) in the middle aged and elderly patients with type 2 diabetes mellitus (T2DM) in Lanzhou communities and analyze its influencing factors.Methods A total of 1 120 individuals having diagnosed T2DM aged 40-75 years in Lanzhou communities were selected.Questionnaire was conducted.Height,weight,blood pressure and lipid were examined.Body mass index (BM1) was calculated.The index were analyzed.Results The patients with HbA1c less than 7.0％ were 453 cases (40.4％,453/1 120),and HbA1c more than or equal to 7.0％ were 667cases (59.6％,667/1 120).The target rate of HbA1c in the patients receiving life style,one oral antidiabetic drug,more oral antidiabetic drug,insulin therapy were 49.2％(94/191),45.7％(182/398),41.5％(88/212) and 27.9％(89/319),respectively.The target rate of HbA1c were 38.6％(192/298),32.2％(49/152),32.7％(49/150),27.0％(85/315) in the patients overweight or obese,with macro or micro vascular complication,and 60.0％ (12/20),44.4％(200/450),41.6％(404/970),45.7％(368/805) in the patients without overweight or obese and macro or micro vascular complication,and there were significant differences (P ＜ 0.01 or ＜ 0.05).Multivariate Logistic regression analysis showed that the extension duration of diabetes,increased BMI,combining with macro or micro vascular complication and gradual strengthening antidiabetic treatment were independent risk factors for HbA1c target (P ＜ 0.05).Conclusions Current status of HbA1c control in the middle aged and elderly patients with T2DM in Lanzhou communities is not optimistic,which is affected by many factors,suggesting that professional education on management should be further strengthened.And optimal treatment programs and individualized comprehensive treatment are needed for most patients to improve glycemic control.