老年2型糖尿病共病患者糖化血红蛋白达标的影响因素

Influencing factors of glycated hemoglobin level in elderly patients with comorbid type 2 diabetes mellitus

摘要:

目的 评估上海市某三级医院老年2型糖尿病共病患者糖化血红蛋白(HbA1c)达标情况及影响因素。方法 根据临床指南自行设计糖尿病共病患者调查表,对2020年9月至12月入住复旦大学附属华东医院内科的284例老年2型糖尿病共病患者进行横断面研究。采用SPSS 23.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ²检验进行组间比较。采用logistic回归分析影响HbA1c达标的因素。结果 284例患者用药品种数为(2.04±0.88)种,其中使用率最高的降糖药物是二甲双胍；61.6%(175/284)的患者仅使用口服药物治疗,而HbA1c达标率为68.0%(193/284)。logistic回归分析结果显示,病程、共病个数、降糖药物的给药途径是影响老年糖尿病共病患者HbA1c达标的危险因素(P<0.05)。结论 老年糖尿病共病患者血糖达标率仍有待提升,临床应加强其共病管理,制定个体化治疗方案,保障临床合理用药。

Abstract:

Objective To evaluate the success rate of glycosylated hemoglobin (HbA1c) control in the elderly patients with comorbid type 2 diabetes mellitus (T2DM) and its influencing factors in a Shanghai tertiary hospital. Methods According to clinical guidelines, a questionnaire was designed for a cross-sectional study to investigate 284 elderly patients with comorbid T2DM, who were admitted to the Internal Medicine Department of Huadong Hospital Affiliated to Fudan University from September to December 2020. Data analysis was performed using SPSS statistics 23.0. According to the data type, t-test or χ² test was used for comparison between groups. Logistic regression was performed to analyze the factors affecting the success rate of HBA1c control. Results The number of comorbidities was (2.04±0.88) in the 284 cases of patients, and metformin was the most widely used hypoglycemic drug. 61.6% patients (175/284) were treated with oral anti-diabetic only, and the success rate of HbA1c control was 68.0% (193/284). Logistic regression analysis showed that the course of T2DM, the number of comorbidities and the route of administration of hypoglycemic drugs were risk factors of success rate of HbA1c control (P<0.05). Conclusion The rate with target HbA1c level in elderly patients with comorbid T2DM needs to be further improved, warranting strengthened management of comorbidities, an individualized treatment plan and rational medication in clinical practice.