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目的了解2型糖尿病患者血糖化血红蛋白(HbA1c)控制水平与自我管理相关因素的关系。方法采用横断面调查的方法,从4个城市15家医院内分泌科门诊连续募集现患病例。由经过统一培训的调查员采用问卷调查的方式收集患者的一般人口学信息、自我管理信息,同时采集患者5μl指尖血送各城市指定医院进行HbA1c检测。运用logistic回归模型探讨自我管理相关因素与患者HbA1c控制水平的关系。结果共收集有效问卷1524份。多因素分析结果显示控制饮食(OR=0.49,95%CI:0.34～0.72),遵从医嘱(OR=0.63,95% CI:0.40～0.98),监测血糖(≤4次/月:OR=0.66,95% CI:0.50～0.87;>4次/月:OR=0.51。95% CI:0.36～0.73),知晓糖尿病相关知识(OR=0.60,95% CI:0.46～0.80)和检测HbA1c(≥3次/年:OR=0.33,95% CI:0.23～0.48;0～3次/年:OR=0.57,95% CI:0.43～0.74)是HbA1c控制的促进因素。结论自我管理有助于2型糖尿病患者的HbA1c控制,建议加强患者的自我管理以促进HbA1c控制。
Objective To investigate the relationship between the control of hemoglobin A1c (HbA1c) and related factors of self-management in type 2 diabetic patients. Methods The method of cross-sectional survey was used to recruit current cases from endocrinology clinics of 15 hospitals in 4 cities. The unified training of investigators to collect the patient’s general demographic information, self-management information, and collected 5μl finger blood of patients sent to designated hospitals in cities for HbA1c detection. Using logistic regression model to explore the relationship between self-management related factors and the level of HbA1c in patients. Results A total of 1524 valid questionnaires were collected. Multivariate analysis showed that diet controlled (OR = 0.49, 95% CI: 0.34-0.72), obeys doctor’s orders (OR = 0.63, 95% CI: 0.40-0.98) (OR = 0.60, 95% CI: 0.46 ~ 0.80) and detection of HbA1c (≥3 (95% CI: 0.50-0.87; OR = 0.33, 95% CI: 0.23 ~ 0.48; 0 ~ 3 times / year: OR = 0.57, 95% CI: 0.43 ~ 0.74) was the promoting factor of HbA1c control. Conclusion Self-management contributes to HbAlc control in patients with type 2 diabetes, suggesting that patients be self-managed to promote HbA1c control.