健康状态分层视角下老年2型糖尿病病人血糖管理现况调查

doi:10.3969/j.issn.1003-9198.2023.06.013

Abstract

Abstract: Objective To explore the proportion, demographic and clinical characteristics of different health status stratifications in the elderly patients with type 2 diabetes mellitus (T2DM), and to analyze the blood glucose control level and the status of blood glucose attainment under different guidelines. Methods After a comprehensive evaluation of comorbidity, cognition and daily activities, the 253 elderly patients with T2DM were divided into good health group(n=87), intermediate health group(n=133)and poor health group(n=33). Demographic data, clinical characteristics and the compliance rate of blood glucose were compared among the three groups. Results Gender, age, marriage, living style, education level, drinking, complications, course of disease, diastolic blood pressure and insulin use showed significant differences among different stratification groups (P<0.05). Of all the patients, 44.3% (112/253) presented with glycosylated hemoglobin (HbA1c) value ＜7%. The control rate of blood glucose was 48.3% (42/87),41.4% (55/133)and 45.5% (15/33) in good health group,intermediate health group and poor health group, with no statistical difference (χ²=1.043, P=0.594). With the 2020 edition of the guidelines as reference, the HbA1c control rate of the three groups was 63.2% (55/87),66.9% (89/133) and 72.7%(24/33), respectively, which increased by 14.9%, 25.5% and 27.2%. According to the 2021 edition of the guideline, the control rate of HbA1c in the three groups decreased by 18.4%, 29.3%and 33.3%, respectively, compared with the 2020 edition.The HbA1c control rate was less than 40% in the poor health group, and the proportion of those who failed to meet the standard due to low blood glucose value was higher than that of those with high blood glucose value. Conclusions On the perspective of health status stratification, the level of HbA1c in the elderly patients with T2DM is low, and a considerable proportion of the patients have not met the standard recommended by the guidelines.In clinical practice, it is necessary to set glycemic control targets in combination with stratification and the use of drugs with high risk of hypoglycemia, so as to promote safer and more effective management.

Key words: type 2 diabetes mellitus, aged, health status, diabetes management

CLC Number:

R 587.1

ZONG Qian-xing,ZONG Xiao-yan,WANG Xue-fei, TAO Lu, GUO Chun, TANG Wei, WU Hai-di, LIU Dong-mei, FAN Yao, MO Yong-zhen. A survey of blood glucose management in elderly patients with type 2 diabetes mellitus from the perspective of health status stratification[J]. Practical Geriatrics, 2023, 37(6): 590-594.

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A survey of blood glucose management in elderly patients with type 2 diabetes mellitus from the perspective of health status stratification

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