Management status of type 2 diabetes mellitus in tertiary hospitals in Beijing: gap between guideline and reality

摘要

Background Diabetes has become one of the most common chronic diseases and the third leading cause of death in China.Many programs have been initiated at national and local levels to address the illness.However,the effect of these programs in daily outpatient clinics is still unclear.The objective of this study was to investigate the management status of type 2 diabetes mellitus (T2DM) and factors associated with it in diabetes clinics of tertiary hospitals in Beijing.Methods A cross-sectional survey was conducted in six tertiary hospitals in Beijing.Control criteria were defined based on 2007 China guideline for type 2 diabetes (CGT2D).Results A sample of 1151 patients,age (60.8±9.2) years,and with a median disease duration of 7.3 years was included.The hemoglobin A1c (HbA1c) mean level was (7.15±1.50)％,the percentage of patients achieving the targets for HbA1c was 37.8％,blood pressure 65.6％,triglyceride (TG) 48.8％,high-density lipoprotein (HDL) 59.2％,low-density lipoprotein (LDL) 34.0％,and total cholesterol (TC) 42.0％ The factors independently associated with glycemic control were diabetes duration (odds ratio (OR) =0.95; 95％ confidence interval (C/): 0.919-0.982,P ＜0.01),body mass index (BMI) (OR=0.914,95％ CI: 0.854-0.979,P=0.01) and smoking (OR=0.391,95％ CI: 0.197-0.778,P＜0.01).The factors independently associated with blood pressure control were BMI (OR=0.915,95％ CI: 0.872-0.960,P ＜0.01) and male gender (OR=0.624,95％ CI: 0.457-0.852,P ＜0.01).The factor independently associated with LDL control was education level (OR=1.429,95％ CI: 1.078-1.896,P=0.013).Conclusions The management status of T2DM patients in tertiary hospitals in Beijing has improved remarkably.However,there is still room for further improvement to reach the guideline target.Long diabetes duration,high BMI,smoking,male gender and low education level were independently associated with poor metabolic control.