Analysis of glycemic control indices in 304 diabetic patients
10.3724/SP.J.1008.2014.00852
- Author:
Jin CHEN
1
Author Information
1. Department of Endocrinology, Changhai Hospital, Second Military Medical University
- Publication Type:Journal Article
- Keywords:
Control status;
Glycosylated hemoglobin A;
Outpatients;
Type 2 diabetes mellitus
- From:
Academic Journal of Second Military Medical University
2014;35(8):852-859
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the controlling status of glucose metabolic indices of outpatients with type 2 diabetes mellitus (T2DM) who were treated in our hospital for a long term, so as to provide theoretical evidence for better management of the blood glucose. Methods From March 1, to April 30, 2012, the clinical and laboratory data of the latest 3 months of 304 T2DM patients were collected. According to the hypoglycemic therapies, the patients were divided into oral hypoglycemic drug treatment group (group A), pure insulin treatment group (group B), and oral medicine combined with insulin treatment group (group C). The status of metabolism indices and the relationship between the controlling status of metabolic indices and complications were explored. Results (1) The mean hemoglobin A1c (HbA1c) of the 304 T2DM patients was (8.01±1.14)%, with only 13.16% of them reaching the recommended glycemic level (<7.0%). We also found that 74.67%(227/304) of patients had at least one complication or concomitant disease. The 2 h-postprandial glucose at diagnosis was found correlated with the number of macrovascular diseases (r=0.131, P=0.024). (2) The glycemic control in group B and C was significantly better than that in group A (all P<0.05). Sulphonylureas and biguanides were still the most commonly used hypoglycemic agents. Premix insulin analog (accounting for 50.85%, 30/59) and intensive insulin therapy (accounting for 27.12%, 16/59) were the commonly used insulin therapy. (3) Patients who performed self-monitoring of blood glucose (SMBG) a week before filling our form in group A, B, and C accounted for 27.56%, 57.63% and 50.85%, respectively. And the control of glycosylated HbA1c, fasting blood glucose and postprandial glucose of these performing SMBG was better than those not performing in the same group (P<0.01 for all). (4) Logistic regression analysis indicated that performing SMBG was an influencing factor (OR=0.379, P=0.007) of poor glycemic control (glycosylated hemoglobin A1c ≥7%). Conclusion Poor control of glycosylated HbA1c remains to be a great challenge for treatment of diabetes. Treatment strategy should be adjusted promptly when glycemic control fails to achieve the recommended level, including starting insulin therapy and adjusting amount of insulin amount.
