【摘要】 目的 探究社区2型糖尿病患者健康管理依从性与血糖控制达标的关系。方法 以淮安区2 171例纳入社区健康管理的2型糖尿病患者为研究对象。采用《糖尿病治疗依从性问卷》综合评估药物治疗、饮食、运动、自我监测及定期复查等维度依从性，并以得分的中位数作为依从性好\差的分界点；将HbA_lc<7.0%定义为血糖控制达标；采用logistic回归评估依从性与血糖控制达标关系。结果 调整混杂因素后，相对于依从性差组，具有良好药物治疗、饮食、运动、自我监测、复查及总体依从性组的血糖控制达标OR分别为1.402（95%CI:1.173～1.677）、1.231（95%CI:1.030～1.471）、0.985（95%CI:0.821～1.183）、0.968（95%CI:0.806～1.162）、1.107（95%CI:0.924～1.326）和1.050（95%CI:0.880～1.252）。进一步剔除合并高血压、冠心病、脑卒中及肿瘤的患者后显示，相对于依从性差组，具有良好药物治疗、饮食、运动、自我监测、复查及总体依从性组的血糖控制达标OR分别为1.987（95%CI:1.321～2.990）、1.606（95%CI:1.077～2.397）、1.282（95%CI:0.867～1.895）、1.378（95%CI:0.910～2.085）、1.663（95%CI:1.126～2.456）和1.593（95%CI:1.077～2.354）。结论 提高社区2型糖尿病健康管理依从性有助于改善患者血糖控制达标率，其中坚持药物治疗及饮食控制的血糖控制效果明显。更多还原

【Abstract】 Objective To explore the association between adherence to community-based health management and glycemic control in individuals with type 2 diabetes mellitus（T2DM）. Methods The study encompassed 2 171 T2DM patients engaged in community health management in Huai’an District, Jiangsu Province. Adherence across five domains—medication, diet, exercise, self-monitoring, and hospital medical check-ups—was evaluated using the Diabetes Regimen Adherence Questionnaire. Adherence was classified as good or poor based on median scores, while glycemic control was defined by HbA_1c levels below 7.0%. Logistic regression models were utilized to assess the association between health management adherence and glycemic control. Results After adjusting for confounding factors, the OR for achieving glycemic control among patients with good adherence in medication, diet, exercise, self-monitoring, hospital medical check-ups, and overall adherence were 1.402（95%CI:1.173-1.677）, 1.231（95%CI:1.030-1.471）, 0.985（95%CI:0.821-1.183）, 0.968（95%CI:0.806-1.162）, 1.107（95%CI:0.924-1.326） and1.050（95%CI:0.880-1.252）, respectively, compared to those with poor adherence. In a subsequent analysis excluding patients with concurrent hypertension, coronary heart disease, stroke, and tumors, the OR were 1.987（95%CI:1.321-2.990） for medication, 1.606（95%CI:1.077-2.397） for diet, 1.282（95%CI:0.867-1.895） for exercise, 1.378（95%CI:0.910-2.085） for self-monitoring, 1.663（95%CI:1.126-2.456） for hospital medical check-ups, and 1.593（95%CI:1.077-2.354） for overall adherence. Conclusion Improved adherence to community health management significantly enhances glycemic control in T2DM patients, with substantial improvements observed through meticulous adherence to medication and dietary guidelines.更多还原