天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (10): 1096-1101.doi: 10.11958/20191410

• 流行病学调查 • 上一篇    下一篇

2型糖尿病合并超重或肥胖患者短期综合干预前后效果分析

王慧,王娇,刘红伟,鲁瑞,李长平,马骏   

  1. 天津医科大学
  • 收稿日期:2019-05-10 修回日期:2019-08-19 出版日期:2019-10-15 发布日期:2019-11-11
  • 通讯作者: 马骏 E-mail:junma@tmu.edu.cn
  • 基金资助:
    2017年度教育部人文社会科学研究项目

Effect analysis of short-term comprehensive intervention in patients with type 2 diabetes mellitus complicated with overweight or obesity

    

  1.  
  • Received:2019-05-10 Revised:2019-08-19 Published:2019-10-15 Online:2019-11-11
  • Supported by:
     

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摘要： 摘要：目的 探讨短期综合干预方式对于2型糖尿病合并肥胖或者超重患者血糖的控制效果及影响因素。方法 对2018年入组的天津市47家医院的糖尿病合并超重或肥胖的患者进行基线问卷调查（包括性别、年龄、糖尿病相关信息等），体格测量（身高，体重，腰围等）和生化检验（包括空腹血糖(FPG)、餐后 2h 血糖(2h PBG)和糖化血红蛋白(HbA1c)），并对干预3个月后的生化指标进行测量。采用SAS 9.4软件进行χ^2 检验，单因素和多因素非条件logistic回归分析。结果 987例糖尿病合并超重或肥胖患者中，肥胖患者738例(74.8%),中心性肥胖患者872例(88.3%)；综合干预前后各项血糖指标之间存在显著性差异(P < 0.001)；3个月干预有效率为65.75%(649/987)；单因素非条件logistic回归分析结果显示，年龄、病程以及三餐是否规律3个影响因素均具有统计学意义(P < 0.001)；多因素logistic回归分析结果显示，三餐饮食正常是3个月综合干预有效的保护因素(OR = 1.992, 95% CI: 1.466-2.706)，病程≥10年 ( OR( 95% CI )：病程10-15年：0.555 ( 0.37~0.831 )；病程≥15年: 0.546 ( 0.357~0.834 ))和年龄≥60岁(OR = 0.604, 95% CI:0.404~0.904 )是3个月综合干预有效的危险因素。结论 对2型糖尿病合并超重或肥胖患者实施综合干预，可以有效的提高糖化血红蛋白的达标率，降低患者的各项血糖指标；同时建议建立完善综合干预体系，做到对2型糖尿病合并超重或肥胖患者的早干预、早控制，以提高该人群的血糖达标率。

关键词: 综合干预, 2型糖尿病, 超重或肥胖, 糖化血红蛋白, 影响因素

Abstract: Abstract: Objective To explore the effects and influencing factors of short-term comprehensive intervention on blood glucose control in obese or overweight patients with type 2 diabetes mellitus. Method: Baseline questionnaire survey (including gender, age, diabetes-related information), physical measurement (height, weight, waist circumference, etc.) and biochemical tests (including fasting blood glucose (FPG), postprandial 2H blood glucose (2h PBG) and glycosylated hemoglobin (HbA1c)) were conducted in 47 hospitals in Tianjin in 2018. Biochemical indicators after 3 months of intervention were included. χ^2 test, univariate and multivariate unconditional logistic regression were analyzed by using SAS statistical package. Results Among 987 diabetic patients with overweight or obesity, 738 (74.8%) were obese and 872 (88.3%) were central obese. There were significant differences in blood sugar indexes before and after comprehensive intervention (P < 0.001); the effective rate of 3-month intervention was 65.75% (649/987). Univariate unconditional logistic regression analysis showed that age, course of disease and regularity of three meals were statistically significant. (P < 0.001); Multivariate logistic regression analysis showed that normal diet was an effective protective factor for 3-month comprehensive intervention (OR = 1.992, 95% CI: 1.466-2.706), course of disease (> 10 years) (OR (95% CI): 10-15 years: 0.555 (0.37-0.831); course (> 15 years: 0.546 (0.357-0.834)) and age (> 60 years) (OR = 0.604, 95% CI: 0.404-0.904) are risk factors for effective 3-month comprehensive intervention. Conclusion Comprehensive intervention for obese and overweight patients with T2DM can effectively improve the standard rate of glycosylated hemoglobin and reduce the blood sugar levels of patients. At the same time, it is suggested to establish and improve the comprehensive intervention system to improve the blood sugar standard rate of this population.

Key words: comprehensive intervention, Type 2 diabetes, overweight or obesity, glycosylated hemoglobin, influencing factors

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