·糖尿病临床研究·

　　老年2型糖尿病患者血糖控制水平及其影响因素的观察

　　韩晓菲 田慧 邵迎红 苗新宇 杨彦 方福生 闫双通

　　【摘要】目的 研究老年T2DM患者血糖控制的影响因素。方法 自1996年起，以2009年为截点，对一组年龄≥60岁老年T2DM患者进行多层面的糖尿病优化管理，分为60岁以前患病(O-DM)组和60岁以后患病(N-DM)组，评估血糖控制情况，分析影响因素。 结果 随访13年，2009年纳入研究的共350例，其中O-DM 组136例，N-DM组 214例。总体HbA1c <6.5%占51.4%，HbA1c<7.0%占76.6%。N-DM组和O-DM组HbA1c<6.5%各占63.1%和33.1%，HbA1c<7.0%各占86.0%和61.8%(P均<0.01)。O-DM组多种口服降糖药和胰岛素治疗者(82.3%)远多于N-DM组(36.9%)。 Logistic回归分析显示，糖尿病病程长(OR：1.03，P=0.044，95%CI：1.001~1.068)、降糖治疗方式升级(OR：2.61，P=0.000，95%CI：1.837~3.716)是老年T2DM患者血糖控制差的主要影响因素。结论 通过优化管理可使老年T2DM患者良好控制血糖。N-DM组血糖控制优于O-DM组，糖尿病病程及降糖治疗方式是老年糖尿病患者血糖控制的主要影响因素。

　　【关键词】 老年;糖尿病，2型;优化管理;血糖控制;影响因素

Observation of blood glucose control and influencing factors in elderly type 2 diabetic patients HAN Xiao-fei ,TIAN hui, SHAO Ying-hong, et al. Department of Geriatric Endocrinology, General Hospital of PLA, Beijing 100853,China

Corresponding author:TIAN Hui,E-mail:tianhui@medmail.com.cn

　　【Abstract】Objective To study the influencing factors of blood glucose control in elderly T2DM patients. Methods Multifaceted optimal management of diabetes (HbA1c compliance<6.5%) ,including a group of elderly whose age was 60 or older ,was carried out in our hospital from 1996. Taking 2009 as the cut-off point ,the subjects were divided into old diagnosed diabetes (O-DM) and new diagnosed diabetes (N-DM).We assessed the blood glucose control and analysised the influencing factors.Results A total of 350 cases(136 O-DM and 214 N-DM) were enrolled in the study after 13 years’follow up from 1996 to 2009. The propotion of patients was 51.4% whose HbA1c could be controlled less than 6.5% and 76.6% whose HbA1c less than 7% in total patients. The propotion of patients achieving the goal of HbA1c less than 6.5% was 63.1% in N-DM and 33.1% in O-DM. Changing the cutoff values to 7.0% from 6.5%, the propotion is 86.0% and 61.8% respectively.The antidiabetic therapy rate of oral antidiabetic agents and insulin were higher in O-DM than N-DM patient. Logistic regression analysis showed that the longer duration of diabetes(OR：1.03，P=0.044,95%CI：1.001~1.068) and antidiabetic treatment upgrade (OR：2.61，P=0.000,95%CI：1.837~3.716)were the main influencing factors of poor glycemic control in elderly patients. Conclusion The blood glucose could be controlled well in elderly patients with T2DM by the optimizing management. N-DM group had better blood glucose control than O-DM group .The main influencing factors of blood glucose control in elderly patients were duration of diabetes and the treatment methods.

　　【Key words】Eldly; Diabetes mellitus，type 2; Optimal management ;Blood glucose control; Influencing factors