Ⅱ型糖尿病患者饮食、运动疗法与糖化血红蛋白控制现状及相关因素分析*

陈玉敏王椿黄慧冉兴无

(四川大学华西医院内分泌代谢科， 四川 成都 610041)

【摘要】目的了解Ⅱ型糖尿病(T2DM)患者饮食控制、运动疗法和糖化血红蛋白(HbA1C)控制现状及相关影响因素。 方法随机抽取T2DM患者61例，对患者进行个人基本资料、糖尿病饮食治疗、运动治疗状况调查，分析影响HbA1C控制的相关因素。结果糖尿病饮食治疗、运动治疗依从率分别为68.8%和68.85%，HbA1C达标率36.07%。年龄<50岁HbA1C均值低于>50岁患者，且有统计学差异[(7.3±1.54)% vs (8.5±2.06)%，P=0.01]。小学及以下文化程度患者(9.20±2.06)%HbA1C均值明显高于初中(7.35±1.52)%、高中(7.45±1.79)%、大专及以上(8.22±2.01)%文化程度患者，差异有统计学意义(P=0.049)。HbA1C与文化程度、吸烟史、糖尿病病程、体重指数(BMI)、饮食控制情况及平均每日运动时间之间无明显相关性(P>0.05)。结论T2DM患者饮食和运动治疗的依从率及HbA1C达标率较之前有提高，但仍未达到满意水平。加强无糖尿病家族史、低文化程度及老年糖尿病患者的糖尿病知识健康教育对血糖的控制有重要的临床意义。

【关键词】Ⅱ型糖尿病； 饮食治疗； 运动治疗； 糖化血红蛋白

【中图分类号】R 587.1

【文献标志码】A

doi：10.3969/j.issn.1672-3511.2015.10.014

Abstract【】ObjectiveTo investigate the status of diet, exercise, HbA1C in type 2 diabetic(T2DM) patients and analyze the related factors of HbA1C. Methods61 patients were enrolled. All subjects were asked to finish the questionnaires of general information, diet status and exercise behaviors and physical examination, be registered value of HbA1C. Influence factors of HbA1C were analyzed. ResultsThe compliance rate of diet therapy, exercise therapy and the control rate of HbA1C respectively were 68.8%, 68.85% and 36.07% in T2DM patients. The subjects under the age of fifty had a lower HbA1C level than those more than fifty years old [(7.3±1.54)% vs (8.5±2.06)%，P=0.01]. The patients with education background below primary school(7.35±1.52)% had a higher HbA1C level among those with junior middle school education (7.35±1.52)%, high school education (7.45±1.79)% and college degree or above(8.22±2.01)% (P=0.049). HbA1C level is not significantly relevant to patients’ education, smoking, course of diabetes, BMI, diet control and daily exercise period (P>0.05). ConclusionsThe compliance rate of diet therapy, exercise therapy and the control rate of HbA1C in T2DM patients are better than before. Strengthening diabetes education might promote the glucose control on the elder T2DM patients, diabetics with poor education or without diabetes family history.

基金项目：中华医学会2014专题研究项目(2014CB536214)

通讯作者：黄慧,《西部医学》编委，E-mail: sansan1880@126.com

收稿日期：( 2015-07-01； 编辑： 陈舟贵)

Situation analysis on diet, exercise, HbA1C and its related factors in type Ⅱ diabetic patientsCHEN Yumin,WANG Chun,HUANG Hui,etal

(DepartmentofEndocrinologyandMetabolism,WestChinaHospital,SichuanUniversity,Chengdu610041,China)

【Key words】Type 2 diabetes mellitus； Diet therapy； Exercise therapy； HbA1C

不良的生活方式与T2DM发病密切相关。不良的饮食习惯，如摄食大量高能量物质以及食用含脂肪和蛋白含量较多的食物，与糖尿病前期、胰岛素抵抗关系密切[1]，并可能缩短糖尿病前期衍变为糖尿病的进程[2]。而生活方式的改变可以改善空腹血糖、增加胰岛素敏感性、减少糖尿病的发生率，并减少向糖尿病并发症发生的风险[3, 4]。良好……