Epidemiological Study On The Pre-diabetes Mellitus Based On The Threelevel Disease Control Network System

Objectives: To describe the epidemiological characteristics of pre-diabetes mellitus and diabetes mellitus absence of symptoms,to explore the diabetes mellitus screening pattern by diabetes mellitus screening on the community adult population,to analyze the relationship between the various glucose metabolic statuses and other metabolic indicators,and to learn the difference in the biochemistry indicators among the various pre-diabetes mellitus statuses,which will provide the orientations for early diabetes mellitus prevention and control based on the three-level disease control network system.Methods: Stratified cluster random sampling was used to select the local residents aged over 20 years old in 6 towns from Yinzhou District.All the participators underwent the oral glucose tolerance test in addition to the routine check-up.The epidemiological characteristics of pre-diabetes mellitus and diabetes mellitus were described.The relationships between the various glucose metabolic statuses and other metabolic indicators were analyzed,in cross-section study.The data of the pre-diabetes cases aged from 20 to 64 years old was collected to analyze the difference in the biochemistry indicators among the various pre-diabetes mellitus statuses.The data was collected and cleared,and then statistical analyses were finished in PASW statistics and EXCEL2003.Results:1.The crude detection rate of diabetes mellitus was 6.68% and the adjusted one was 4.67%.The standard population was the average Ningbo population in 2012.There was no significant difference between the detection rates of the female and the male(χ2=2.68,P=0.101).The age-specific detection rates ranged from 0 to 13.44% and increased with age(trend χ2=141.21,P=0.000).2.The crude detection rate of pre-diabetes mellitus was 19.13% and the adjusted one was 13.52%.There was a significant difference between the detection rates of the female and the male(χ2=4.27,P=0.039).The age-specific detection rates ranged from 3.65% to 30.07%,and increased with age(trend χ2=273.44,P=0.000).3.The most common type of pre-diabetes mellitus was isolated-impaired glucose tolerance,the proportion of which was 64.93%.And the proportions of the isolatedimpaired fasting glucose and combined IFG and IGT were 19.45% and 15.62% respectively.There was little agreement between the fasting glucose values and 2 hour oral glucose tolerant test plasma glucose values.(Kappa=0.25,P=0.000).4.According to the indicators of body mass index,fasting glucose,2 hour oral glucose tolerant test plasma glucose,systolic blood pressure,diastolic blood pressure and triglyceride,there were significant differences among the groups of normal glucose regulation,pre-diabetes mellitus and diabetes mellitus.The groups of pre-diabetes mellitus and diabetes mellitus both had higher values of those indicators than that of normal glucose regulation.The multinomial logistic regression analysis was given,and the results showed that age,overweight(or obesity),hypertension,and dyslipidemia were risk factors of diabetes mellitus and pre-diabetes mellitus.5.According to the indicators of total cholesterol,low density lipoproteincholesterol,hemoglobin A1 c,fasting insulin,and HOMA-IR index,the groups of combined IFG and IGT(or isolated-impaired glucose tolerance)was in a higher risk status than that of isolated-impaired fasting glucose.Conclusions:1.The adjusted detection rates of diabetes mellitus and pre-diabetes mellitus were 4.67% and 13.52%,respectively.2.The most common type of pre-diabetes mellitus was isolated-impaired glucose tolerance.More than half numbers of the diabetes mellitus and pre-diabetes mellitus were probably omitted if the fasting glucose was tested alone.3.It was feasible in practice to adopt 2 hour oral glucose tolerant test in the routine check-up of the new rural cooperative medical care system.4.Age,overweight(or obesity),hypertension,and dyslipidemia were risk factors of diabetes mellitus and pre-diabetes mellitus.5.The groups of combined IFG and IGT(or isolated-impaired glucose tolerance)were in a higher risk status than that of isolated-impaired fasting glucose in some respects.