Abstract:Objective To explore the effects of family history, obesity and diabetes self-management behavior (DSMB) on hemoglobin A1c (HbA1c) control and achievement among patients with type 2 diabetes mellitus (T2D) in Chinese primary medical institutions. Methods A cross-sectional analysis was conducted in T2D outpatients or inpatients successively treated in 5 diabetes specialized chain hospitals from January 2016 to December 2019, and their information was stored in the diabetes shared-care information system. HbA1c achievement (HbA1c < 7.0%) or not and the general status were compared between the two groups. Multivariate logistic regression analysis was performed to identify factors related to HbA1c non-achievement. Results A total of 8,506 patients were enrolled in this study, with 27.75% of patients achieving HbA1c targets. There were 2,860 (33.62%) cases with positive family history and 1,541 (18.12%) cases with obesity. As for HbA1c achievement or not, statistically significant differences were found between the two groups in terms of age, diabetes duration, body mass index,smoking, education background, dietary adherence, physical exercise, adherence to blood glucose monitoring, medication compliance and therapeutic regimen (all P<0.05). Multivariate logistic regression analysis showed that obesity (OR=1.226, 95%CI:1.042-1.441) and long duration (OR=1.019, 95%CI:1.009-1.028) increased the risk of HbA1c non-achievement, while oral therapy alone (OR=0.388, 95%CI:0.345-0.436), medication compliance (OR=0.805, 95%CI:0.699-0.928) and regular exercise (OR=0.886, 95%CI:0.786-1.000) decreased the risk of HbA1c non-achievement. Conclusion This study suggests that the achievement rate of HbA1c in T2D patients in Chinese primary medical institutions is low. Therapeutic regimen, medication compliance, regular exercise and obesity are factors related to HbA1c achievement. In clinical practice, special attention should be paid to patients treated with insulin or with obesity, and patients' compliance in medication and regular exercise.
安凌王, 王丹丹, 邢海洋, 陈林慧, 汤虹, 李伟婷, 陆菊明. 家族史、肥胖及自我管理行为在2型糖尿病患者糖化血红蛋白达标中的作用[J]. 实用预防医学, 2021, 28(10): 1169-1173.
AN Ling-wang, WANG Dan-dan, XING Hai-yang, CHEN Lin-hui, TANG Hong, LI Wei-ting, LU Ju-ming. Effects of family history, obesity and self-management behavior on hemoglobin A1c achievement in patients with type 2 diabetes mellitus. , 2021, 28(10): 1169-1173.
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