【摘要】 背景我国成年2型糖尿病及糖尿病前期患病率高,但糖尿病治疗率和治疗控制率低。糖尿病前期人群可出现糖尿病并发症,且患病率高于正常人群。目前社区糖尿病管理针对糖尿病前期的干预、慢性并发症筛查、科普宣传等缺乏相应的证据。目的调查、分析社区2型糖尿病及糖尿病前期人群糖尿病管理现状,为优化社区糖尿病管理提供依据。方法选取2020年11月—2021年1月在上海市安亭、真如、曹杨、青村、桃浦社区卫生服务中心就诊的糖尿病前期人群101例及2型糖尿病患者1 055例。采用流行病学调查方法,向调查对象发放流行病学调查表。收集调查对象一般资料,并比较糖尿病前期人群和2型糖尿病患者生活方式干预率、药物治疗率、慢性并发症筛查率及科普宣传教育率。结果 2型糖尿病患者生活方式干预率和药物治疗率高于糖尿病前期人群(P<0.05)。糖尿病前期人群慢性并发症筛查率为19.8%(20/101),低于2型糖尿病患者的78.6%(829/1 055)(P<0.001)。已行慢性并发症筛查的糖尿病前期人群中未发现糖尿病慢性并发症,低于2型糖尿病患者的24.7%(205/829)(P=0.022)。糖尿病前期人群接受科普宣传教育率为27.7%(28/101),低于2型糖尿病患者的67.2%(709/1 055)(P<0.001)。结论社区糖尿病前期人群的生活方式干预率、慢性并发症筛查率及接受科普宣传教育率均明显低于2型糖尿病患者,提示社区对糖尿病前期人群管理重视程度不足,亟待改进。更多还原

【Abstract】 Background The prevalence of adult type 2 diabetes and prediabetes is high，but the rates of treatment and control of diabetes are low in China.Prediabetic patients have higher risk and prevalence of diabetic complications compared to the general population.There is currently a lack of evidence on community diabetes management in terms of interventions，screening for chronic complications，and scientific popularization and education of the knowledge about prediabetes.Objective To investigate and analyze the community-based management of diabetic and prediabetic populations，providing evidence for optimizing community-based diabetes management.Methods An epidemiological survey using the Epidemiological Questionnaire on Type 2 Diabetes and Prediabetes was conducted from November 2020 to January 2021 among 101 prediabetic patients and 1 055 type 2 diabetic patients selected from five community health centers(Anting，Zhenru，Caoyang，Qingcun，and Taopu) in Shanghai，covering the sociodemographic information，prevalence of receiving lifestyle interventions，medication treatment and screening for chronic complications，prevalence of chronic complications，and receiving the scientific popularization of the knowledge about type 2 diabetes and prediabetes.The data of type 2 diabetic and prediabetic patients were compared.Results Compared to prediabetic patients，type 2 diabetes patients had higher prevalence of using lifestyle interventions and medication treatment(P<0.05).Moreover，they also had higher prevalence of screening for chronic complications〔78.6% (829/1 055) vs 19.8%(20/101)〕(P<0.001).No chronic complications of diabetes were found in the prediabetic population who had been screened for complications，which was lower than that 〔24.7% (205/829)〕of their counterparts (P=0.022).The prevalence of receiving the scientific popularization of the knowledge about type 2 diabetes and prediabetes among the prediabetic population was lower 〔27.7% (28/101) vs 67.2% (709/1 055)〕(P<0.001).Conclusion Community-dwelling prediabetics had lower prevalence of receiving lifestyle interventions，screening for chronic complications and scientific popularization of the knowledge about type 2 diabetes and prediabetes than community-dwelling diabetics，suggesting that community-based management of this population is under-appreciated and needs to be improved.更多还原