Investigation of glycemic control in the patients over 40 years old with type 2 diabetes in communities of Beijing

Abstract

Objective To investigate the current status of the glycemic control in the patients aged 40 or older in the communities of Beijing. Methods Total of 19 470 people aged 40 years or older were enrolled to perform census in the present study from three communities, Gucheng, Jinding and Laoshan, of Beijing from December 2011 to August 2012.Each participant who met the standard received a questionnaire survey, physical examination and laboratory examination (liver and kidney function, serum lipid and hemoglobin glycosylated hemoglobin (HbA1c)). The glycemic control of the patient with type 2 diabetes mellitus(T2DM), which is reported in the questionnaire, was assessed according to the goal of HbA1c<7% advocated by the American Diabetes Association(ADA) and the Chinese Diabetes Society.The t test and ANOVA analysis was used to compare the difference between groups.A logistic regression analysis was made to reveal the characteristics associated with patients attaining HbA1c<7.0%. Result Of the 2 523 patients with type 2 diabetes included in the survey, the mean HbA1c was (7.4±1.8)% and patients who met the glycemic goal (HbA1c<7%) was 45.7%.The oral antidiabetic drugs (OADS) monotherapy, insulin monotherapy, OAD+ Insulin groups had mean HbA1c levels of (7.4±1.6)%, (7.9±2.2)% and (7.9±2.0)%, respectively, and among those three groups, 47.2% (568/1 203), 32.5% (87/268), 26.4%(73/276) of the patients met the goal of HbA1c<7.0%.The mean HbA1c of the patients, treated with one OAD, two OADs and more than three OADs, was (7.3±1.5)%, (7.5±1.9)% and (7.5±1.2)%, respectively, while the percentage of patients who met the glycemic goal of HbA1c<7.0% was 45.0%(472/1 049), 39.6%(149/376) and 37.0%(20/54). As the development of the diabetes, the average of the HbA1c among patients with the duration of less than one year, 1-5 years, 5-10 years and more than 10 years was (7.0±1.5)%, (7.1±1.6)%, (7.4±1.8)% and (7.8±1.9)% and the number of patients with the achievement of HbA1c<7% was 56.4%(195/346), 55.5%(422/760), 44.7%(266/595) and 32.8% (270/822). According to the result of the logistic regression analysis , mean HbA1c achievement of HbA1c<7.0% was related to the female, body mass index, waist hip ratio, systolic blood pressure, complications/comorbidities, duration of diabetes and the therapeutic regimen(OR=1.320, 0.762, 0.027, 0.992, 1.264, 0.431 and 0.432, P<0.05 all above). Conclusions More than half of the patients aged 40 or older with T2DM do not meet the target of glycemic control of HbA1c less than 7.0% in the communities of Beijing.The glycemic goal rate is down as the duration of diabetes. Key words: Communities; Diabetes mellitus, type 2; Glycosylated hemoglobin; Oral antidiabetic drugs; Insulin