| Objective To investigate self-management status of patients with type 2 diabetes and explore the effect of diabetes self-care on glycemic control. To survey the prevalence of chronic complications and related macro-vascular disease in elderly patients with diabetes, and analyze the influencing factors.Methods In the first part of this study, information of T2DM patients was collected in endocrinology clinic by questionnaire survey. Information includes demographic situation, diagnosis, treatment, recent blood glucose control and other metabolic disorders. In the second part, the subjects were elderly hospitalized patients (>60 years old) with T2DM carried out in our department from January 2012 to December 2014.The clinical and laboratory data were analyzed retrospectively and the clinical characteristics were observed.Results 1.325 cases of patients with T2DM were included, with average HbAlc(7.5±1.5)% and total HbAlc target rate(<7%) 40.3%.60% of the patients in this study had received diabetes education,52.3% of the patients could adhere to strict, long-term regular diet,46.8%(152 cases) patients could insist for a long time exercise therapy,56% of the patients could execute regular self blood glucose monitoring. In single factor analysis, HbAlc target rate in patients with diabetes education(45.1%) was higher than that without diabetes education (33.1%,P=0.006); patients with strict, general and without diet control(75%,46.9% and 25.8% respectively) showed significant differences (P=0.000); patients with exercise therapy is higher than that without exercise therapy (respectively 48%,33.5%, P=0.022). Multiple factors Logistic stepwise regression analysis showed that the long duration and diet are the key factors that influence HbAlc control (P<0.05).2. We analyzed 321 male diabetic patients with advanced age (above 80 years old accounted for 61.7%) and long illness duration(18.1±9.6 year). Patients with coronary heart disease accounted for 60.1%, cerebrovascular diseases for 43.0%, lower extremity vascular diseases for 62.0%, diabetic kidney disease for 33.3%, retinopathy for 11.5% and diabetic neuropathy for 20.9%. The prevalence rate of five complications in the>90 years old group is over twice times as high as that of the 60-79 years old group. Cases with>25 years illness duration were at much higher risk to each chronic complication than those diagnosed as diabetes within 15 years (/*< 0.05).Cases in the M-HbAlc≥6.5% group had a higher prevalence rate of coronary heart disease, cerebrovascular diseases, lower extremity vascular diseases, diabetic kidney disease and diabetic neuropathy than those in the M-HbAlc<6.5% group (P< 0.05).Cases in HbAlcSD>0.5 group had a high prevalence rate of each chronic complication (P<0.05).Moreover, cases with hypertension had a high prevalence rate of coronary heart disease, cerebrovascular diseases and diabetic kidney disease (P<0.05).Conclusion In general, only half of the patients with T2DM can have good self-management. Diabetes self-management level is a key factor that influence blood glucose control, and health life style, especially diet control, is the most important for the good future. The group of elderly hospitalized patients with type 2 diabetes had a relatively good control of blood sugar, blood pressure and blood lipid, but the prevalence rate of chronic diabetic complications and related macro-vascular diseases is still high. Risk factors may be age, illness duration, hypertension, long-term blood glucose control level and glucose fluctuation. |
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