Study On Current Situation Of Diabetes Among Residents With 25 Years Old And Above And Its Influencing Factors In Jiayuguan City

BackgroundDiabetes is a chronic disease and a metabolic disorder caused by a variety of reasons.When the pancreas produces deficient insulin or the body can't use the insulin effectively,diabetes occurs,which can cause chronic injuries and function failure of various organs.At present,totally382 million people are suffering from diabetes around the world,and the global number of diabetes patients will exceed 592 million by 2035.The acute and chronic complications of diabetes can harm multiple organs,affect physical and mental health of the patients seriously,and bring heavy burden to the families and society.Along with the rapid economic development,accelerating population aging,and changes of modern people's diet and lifestyle,the prevalence of diabetes has been increasing significantly with an obvious rapid growth rate in China.ObjectivesThis study aims to fully understand the prevalence of diabetes among the residents in Jiayuguan city of Gansu province,analyze the main influencing factors of diabetes prevalence,and identify the weak links of diabetes prevention and control and the key contents of the intervention work in the future,to provide baseline data for future related research.In addition,this study also proposes to know the diabetes knowledge,treatment,and control condition and the control situation of the healer,deeply excavate the health information of resident,and then optimize the grass-roots health services management of chronic diseases,to provide scientific basis for the governments and the administrative departments to make public health policies and measures.Methods1.Respondents:The residents with 25 years old and above who lived in Jiayuguan city more than 6 months were recruited.2.Sampling methods:The stratified sampling method was used to extract the respondents.Step 1:According to the population structure of Jiayuguan and combined with the diabetes prevalence of other cities and counties in Gansu province,totally 10003 respondents were sampled for this study.Step 2:The proportion of every age group was calculated according to the population data of Jiayuguan,so was every age group's samples from 6 community health service centers and 3 township and village health institutions.Step 3:According to the step 1 and 2,the function of randomly selecting cases of SPSS 17.0 software was used to randomly select the investigation objects for household survey or concentrated survey.Step 4:During the survey,the objects who could not participate in the investigation for some reasons were exchanged,and the exchange conditions were that other objects were not extracted before.3.Research contents:We made the questionnaire survey and took the medical examination.The questionnaire contained general demographic characteristics,disease history,family history,personal habits,health knowledge,health behavior and the condition of prevention/treatment in patients with diabetes.Medical examination was involved in measuring blood pressure,blood glucose level,height,and weight and waist circumference and so on.4.Statistical analysis:The statistical indicators were analyzed with SPSS17.0 software.Analysis methods mainly included the statistical description,t tests,?~2 tests,single factor/multi-factor non-conditional Logistic regression analysis and other statistical methods,and the inspection level was?=0.05.The prevalence was standardized by age data from the sixth national population census in 2010.Results1.Epidemiological characteristics of diabetesThis study polled 9540 people,including 4554 males and 4986 females,and 8794 community residents and 746 township residents.Among the residents with 25 years old and above in Jiayuguan,the crude diabetes prevalence of both sexes,male and female were 6.3%,7.2%and5.5%.And the age-standardized diabetes prevalence of both sexes,male and female were 7.2%,7.9%and 6.8%.The difference between male and female was statistically significant(?~2=11.73,P=0.001).The diabetes prevalence increased with age,and the difference was statistically significant(?~2=807.43,P<0.001).The higher level of education,the lower diabetes prevalence;the difference was statistically significant(?~2=293.87,P<0.001),and the highest prevalence was 17.9%among people who were in illiterate/semi-illiterate level.The minority and Han nationality's diabetes prevalence were 9.4%and 6.2%,and the difference was statistically significant(?~2=3.88,P=0.049).There was significant difference between different marital status groups(?~2=51.03,P<0.001),and the prevalence of divorced/widowed group was 13.7%,which was higher than that of other groups.The more annual household income of the family,the lower the prevalence,and the difference was statistically significant(?~2=52.04,P<0.001).Community residents and township residents'diabetes prevalence rate were 6.5%and 3.9%,and the difference was statistically significant(?~2=8.04,P=0.005).2.Diabetes related influencing factorsThe single factor Logistic regression analysis showed that age,gender,educational level,marital status,annual household income,family population,community/township population,eat fruit,family history of diabetes,BMI level,WC level,and hypertension were all relevant influencing factors of diabetes.BMI level and WC level were the same variables to determine the standard of overweight and obese,so we respectively introduced the two variables to the multi-factor Logistic regression analysis model,and the two results all showed that age,male,community residents,family history of diabetes,overweight and obesity(BMI level/WC level),hypertension,educational level and eating fruits often were all relevant factors of diabetes.3.Diabetes prevention and controlThe awareness of diabetes was 64.8%,the treatment was 61.5%,the control was 30.2%,and the healed control was 49.2%.The four indexes between men and women in the difference were not statistically significant(?~2=2.654,P=0.103;?~2=1.470,P=0.225;?~2=0.343,P=0.558;?~2=0.125,P=0.724).As the ways obtaining diabetes knowledge information for the diabetic patients,the top three choices were form doctors,televisions,and family members,whose proportion were 90.0%,30.0%and 19.7%.Most patients took treatment and control measures,67.4%of the patients took oral medications,40.5%took injected insulin;patients who chose diet and exercise were 29.2%and 23.1%,and there were only 0.01%of the patients were without treatment measures.On demand for diabetes knowledge,most patients chose"also need to know some"and"the lack of a lot of",whose proportion were 45.4%and 37.4%respectively.Conclusions1.The diabetes prevalence level was higher among the residents with 25 years old and above in Jiayuguan,which was in the middle level of the whole country,and the upper-middle level in Gansu province.The males'prevalence was higher than the females',and both raised with age.Community residents'prevalence was higher than the rural,and diabetes prevalence was different among each community.2.The risk factors for diabetes were increasing age,male,community residents,family history of diabetes,hypertension,and overweight/obesity,high education level and eating fruits often were the protective factors for diabetes.3.The awareness,treatment and healer control of diabetes had reached good level,but the control condition was still low.The popularizing rate of diabetes-related health knowledge was lower in Jiayuguan city and the diabetes knowledge demand of diabetic was much higher.