| ObjectiveTo assess the status of HbAlc,hypertension,and hyperlipidemia in type 2 diabetic patients in Changshu China,and to study the situation of antidiabetic drug use and identify the potential risk factors.MethodsA cross-sectional survey on diabetes mellitus was conducted from six precincts of urban areas(DaYi Town,MoCheng,Town,OuQu Town,XieQiao Town,XingLong Town and YuShan Town)and six countrysides(MeiLi Town,Ren Yang Town,TangShi Town,XinZhuang Town,YeTang Town and FuShan Town)in Changshu City by multi-stage cluster sampling method.Logistic regression was used to analyze the related factors which could influence the glucose control of diabetes.Results1?Control of hyperglycemia,hypertetion,and hyperlipidemiaTotally 10246 patients with T2DM were investigated,10238 of which completed the survey.The average age of the T2DM patients was 61.4 years.There were 4156 males,accounted for 40.59%.And there were 6082 women,accounted for 59.41%.The median duration was 6.99 years.The average fasting plasma glucose(FPG)was 8.82±2.70mmol/L.The mean HbAlc level was 7.60±1.58%.The avearge of blood pressure was 150/81mmHg.The mean level of TC and TG was respectively 5.24±1.11mmol/L and 1.96±1.60mmol/L.While HDL-C and LDL-C was 1.50±0.41mmol/L and 3.13±0.90mmol/L.There were 83.59%reported comorbid hypertension,dyslipidemia,or both in 10238 patients with type2 diabetes.There were 40.84%of patients achieved the target goal for control of blood glucose(HbAlc<7.0%)by CDS.While 23.32%of patients achieved the goal of HbAlc<6.5%.Only 3.42%achieved blood glucose(HbAlc<7%),blood pressure(systolic blood pressure<140mmHg,diastolic blood pressure<80mmHg),and LDL-C[LDL-C<2.6 mmol/L(uncomplicatedcoronary heart disease)or LDL-C<1.8mmol/L(concomitant coronary heart disease)]all 3 target goals.2.MedicationsThere were 10238 T2DM investigated in Changshu City,about 1470 patients did not recieve any treatment,accounted for 14.36%.While 5934 patients were treated with one drug,accounted for 57.96%.And 2834 patients were treated with combination of two or three antidiabetic medications,accounted for 27.68%.The most common used drugs for type2 diabetes were sulfonylurea(16.37%),insulin(15.87%)and metformin(13.80%).The patients most popular combination was sulfonylurea plus metformin,accounted for 15.84%.The prevalence of hypertension was 63.98%and antihypertensive drugs were used in 89.91%hypertension patients.73.16%of the patients used single antihypertensive drug and 16.75%of which took two or more categories.The most common antihypertensive medications were calcium channel blockers,compound preparations and ARB,accounting for 31.65%,14.69%and 11.62%,respectively.The patients who narrated by themselves with dyslipidemia were 14.35%in T2DM.The utilization rate of lipid-regulating drugs was 19.61%.Statins were the most common medication to lower the cholesterol,accounting for 8.71%.There were 3.31%of the T2DM taking aspirin,and 58.11%of those taking the drug with a history of stroke.3.Risk factorsThe univariate non-conditional logistic regression analysis showed that there were no statistically significant differences in leisure exercise,medical insurance and occupation.The results of multi-factor logistic regression showed that resedence,smoke,dyslipidemia,waist circumference,gender,age,medications,systolic pressure and course of diabetes were influencing factors for achieving the optimum HbAlc goal.ConclusionThe percentage of optimal control of hyperglycemia,hypertetion and hyperlipidemia was not satisfactory in Changshu City.Glycemic control was associated with resedence,smoke,dyslipidemia,waist circumference,age,systolic pressure and course of diabetes.The main medications for patients with type 2 diabetes were the same as the treatment reccommendation of European Association for the Study of Diabetes. |
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