| Objective: To investigate the present status of hypoglycemic schemes in overweight / obese patients with type 2 diabetes mellitus and to explore the influencing factors of glycemic control.Methods: Electing 630 cases of inpatients with type 2 diabetes mellitus and overweight /obesity who were enrolled in accordance with the inclusion criteria at Endocrinology Department of the Second Affiliated Hospital of Dalian Medical University from October 2015 to October 2016 to collect the demographic data.All the patients have kept the hypoglycemic schemes at least for 1 year.Collecting the basic situation,biochemical indicator,hypoglycemic schemes,self management behaviors and so on.Evaluating the effects of treatment and analyze the possible factors affecting plasma glucose by statistical analysis.Results: 1.Basic situation and plasma glucose control: the mean age was(60.12±13.56)years old;mean duration of disease was(9.79±7.26)years;mean body mass index was(28.21±3.07)kg/m2.The prevalence of chronic complications in the top respectively were diabetic neuropathy,neck and / or lower extremity vascular disease and diabetic nephropathy.The mean glycated hemoglobin was(9.17±2.18)%.The glucose eligible rate is 18.1%(114/630).The degree of education and course of disease affect plasma glucose level.The patients who educated from junior high school,high school or technical secondary school,college students above their blood sugar compliance rate respectively were 7.69%,13.56%,20.63% that existing statistically significant difference(P<0.05).Body mass index affected plasma glucose level,the rate of super recombinant blood glucose was higher than that of obese group(P<0.05).2.Hypoglycemic drugs and plasma glucose control: The most commonly used hypoglycemic protocol was insulin combine with oral drugs(46.82%),the next was multiple oral medicine,single oral drugs and oral drugs are mainly alpha glucosidase inhibitors(25.20%),and double guanidine(20.05%).The least was GLP-1 analogue 8.89%(56/630).In the blood glucose control group,GLP-1 analogue,multiple oral medicine,insulin combined oral drugs,single insulin,single oral drugs and not any antidiabetics respectively was 29.82%、26.32%、23.68%、11.40%、7.89%、0.88%.In different course of disease the application rate of single oral drugs,multiple oral medicine,insulin combined oral drugs and GLP-1 analogue has statistically significant difference(P<0.05).In different body mass index the application rate of single insulin and GLP-1 analogue has statistically significant difference(P<0.05).3.The influencing factors to plasma glucose control: During the single factor analysis,found that the BMI,education level,having health insurance or not,disease duration,serum lipid and insulin resistance(HOMA-IR),diet control are the influencing factors of blood glucose;by Logistic regression analysis founded that the education level,diet control are factors for blood glucose;triglyceride(TG),low density lipoprotein(LDL-C)and HOMA-IR are the risk factors of blood glucose.Conclusion: 1.The blood glycemic control of overweight / obese patients with type 2 diabetes mellitus is unsatisfactory.The rate of HbA1c<7% is only 18.1%.During the hypoglycemic therapy the insulin combined with oral drugs were mostly used,GLP-1 analogue was least used and its blood glucose compliance rate was 60.71%.2.Education level and diet are the factors of blood glucose level;TG,LDL-C,HOMA-IR are the risk factors of blood glucose level.3.Overweight / obese T2DM patients should choose hypoglycemic drugs,such as GLP-1 analogues,metformin,acarbose and so on that can reduce or not increase the weight. |
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