일부 도시지역의 당뇨병 관리실태와 혈당관리 수준과 관련된 요인 = Management of Diabetes Mellitus and Factors Associated with Poor Glycemic Control in an Urban Area

다국어 초록 (Multilingual Abstract)

Background: We evaluated the current status of diabetes management and the predictors for poor glycemic control in an urban area.
Methods: This study included 1,138 community-dwelling adults (≥50 years) with diabetes, of which 584 participated in the diabetes care survey. Logistic regression was used to identify the factors predicting poor glycemic control (hemoglobin A1c [HbA1c]≥7%) in the total sample and to evaluate the relationship between the history of diabetes management checkup and poor glycemic control in the diabetes care survey sample.
Results: Of the 1,138 patients, 53.2% had blood pressure less than 130/80 mmHg, 41.7% had fasting glucose between 70 and 130 mg/dL, 48.6% had HbA1c below 7.0%, 60.1% had triglycerides below 150 mg/dL, 41.4%had low density lipoprotein cholesterol below 100 mg/dL, and 59.1% had normoalbuminuria (urine albuminto-creatinine ratio <30 mg/g creatinine). Of the 584 patients completing the diabetes care survey, 63.9% had one or more lipid tests, 32.0% had one or more HbA1c tests, 43.8% had one or more microalbuminuria tests,and 42.5% had one or more fundoscopic examinations annually. Female gender (odds ratio [OR], 1.71; 95%confidence interval [CI], 1.23-2.36), duration of diabetes (OR, 1.07; 95% CI, 1.06-1.09), and alcohol use (OR,1.40; 95% CI, 1.06-1.85) were associated with an increased risk for poor glycemic control while age (OR, 0.97;95% CI, 0.96-0.99) and antihypertensive medication (OR, 0.64; 95% CI, 0.50-0.83) were associated with a decreased risk.
Conclusions: This study shows that glycemic control is likely to be poor in urban areas. We need to develop appropriate community-based strategies to achieve optimal glycemic control and prevent diabetes complications.

국문 초록 (Abstract)

연구배경: 본 연구는 도시지역 당뇨병 환자들의 관리 현황과 혈당 관리에 영향을 미치는 요인들을 파악하고자 하였다.
방법: 본 연구의 대상은 도시지역에 거주하는 50세 이상당뇨병환자 1,138명이며 그중 584명에 대해 당뇨병 관리에 대한 설문조사가 이루어졌다. 당화혈색소가 7.0% 이상일 때 혈당관리가 미흡하다고 정의하고 다변량 로지스틱분석을 이용하여 전체 대상자에서 혈당관리 수준에 영향을 주는 요인들을 파악하였고 당뇨병 관리 설문조사에 응한 584명에서 당뇨병 관리 검사력과 혈당 관리 수준과의관련성을 알아보았다.
결과: 전체 1138명 중 혈압 130/80 mmHg 미만은53.2%, 공복혈당 70-130 mg/dL 41.7%, 당화혈색소 7%미만은 48.6%, 중성지방 150 mg/dL 미만 60.1%, 저밀도지단백 콜레스테롤 100 mg/dL 미만 41.4%, 미세알부민뇨음성 59.1%였다. 당뇨관리 설문조사를 받은 584명 중 최근1년 이내의 합병증 검사비율은 고지혈증 검사 63.9%, 당화혈색소 검사 32.0%, 미세알부민뇨 검사 43.8%, 그리고 안저검사 42.5% 이었다. 다변량 로지스틱 회귀분석에서 여성(odds ratio [OR], 1.71; 95% confidence interval [CI],1.23-2.36), 당뇨병 유병기간(OR, 1.07; 95% CI, 1.06-1.09)이 긴 경우, 음주(OR, 1.40; 95% CI, 1.06-1.85)를 하는 경우에서 혈당관리가 미흡하였고 고연령층에서(OR, 0.97;95% CI, 0.96-0.99), 항고혈압제를 복용(OR, 0.64; 95%CI, 0.50-0.83)한 경우에서 혈당관리가 잘 되었다.
결론: 본 연구는 도시지역 당뇨병 환자들의 당뇨병 관리상태가 좋지 않음을 보여주고 있다. 지역사회 당뇨병 환자들의 적절한 혈당 관리와 합병증의 예방을 위해서는 지역사회에 기반을 둔 관리 대책의 수립이 필요할 것으로 생각된다.

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