Lin Liu1, Qingqing Lou1, Xiaohui Guo2, Li Yuan3, Li Shen4, Zilin Sun5, Fang Zhao6, Xia Dai7, Jin Huang8, Huiying Yang9, John P Mordes10. 1. Jiangsu Province Hospital on Integration of Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China. 2. Department of Endocrinology, Peking University First Hospital, #8 Xishiku Street, Beijing, China. 3. Department of Endocrinology, West China Medical School, West China Hospital, Sichuan University, Chengdu, 610041, China. 4. Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China. 5. Institute of Diabetes, Zhongda Hospital, Medical School, Southeast University, Nanjing, Jiangsu, 210009, China. 6. Department of Endocrinology, China-Japan Friendship Hospital, Beijing, 100029, China. 7. Department of Endocrinology, First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, 530021, China. 8. Nursing Department, Second Xiangya Hospital of Central South University, Changsha, Hunan, 410011, China. 9. Department of Endocrinology, Metabolism, First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan, 650032, China. 10. UMass Medical School, 364 Plantation Street LRB 222, Worcester.
Abstract
BACKGROUND: The prevalence of type 2 diabetes in China is increasing rapidly. Appropriate management of glycemia, blood pressure and dyslipidemia in this population is a major public health concern. OBJECTIVE: The aim of this study was to assess metabolic control including glycated hemoglobin A1c (HbA1c ), blood pressure (BP) and low density lipoprotein cholesterol (LDL-c), in a large sample of patients with type 2 diabetes in China and to identify factors that correlated with the achievement of HbA1c, BP and LDL-c goals (ABCs). METHOD: A nationwide survey was conducted in 50 medical centres across China from April to July of 2010. Baseline information on demographics, medical history, HbA1c , BP and LDL-c levels were measured in 5961 patients with type 2 diabetes. RESULTS: Mean age, body mass index (BMI) and HbA1c were 59.5 ± 1.3 years, 24.5 ± 4.1 kg/m(2) and 8.3 ± 2.2%, respectively. With respect to generally accepted ABC treatment goals, 35.2% of participants had HbA1c <7%; 35.5% had BP < 140/80 mmHg, and 45.1% had LDL-c < 100 mg/dl. The proportion of patients who met all three targets was only 5.4%. Logistic regression revealed that smoking (P=0.000), higher BMI (P=0.001) and insulin use (P=0.000) were statistically significant predictors of failing to meet ABC targets. CONCLUSION: The percentage of Chinese patients with type 2 diabetes who met recommended targets for HbA1c , BP and LDL-c in 2010 was low. Smoking, higher BMI and insulin use were the strongest determinants of failing to meet ABC targets.
BACKGROUND: The prevalence of type 2 diabetes in China is increasing rapidly. Appropriate management of glycemia, blood pressure and dyslipidemia in this population is a major public health concern. OBJECTIVE: The aim of this study was to assess metabolic control including glycated hemoglobin A1c (HbA1c ), blood pressure (BP) and low density lipoprotein cholesterol (LDL-c), in a large sample of patients with type 2 diabetes in China and to identify factors that correlated with the achievement of HbA1c, BP and LDL-c goals (ABCs). METHOD: A nationwide survey was conducted in 50 medical centres across China from April to July of 2010. Baseline information on demographics, medical history, HbA1c , BP and LDL-c levels were measured in 5961 patients with type 2 diabetes. RESULTS: Mean age, body mass index (BMI) and HbA1c were 59.5 ± 1.3 years, 24.5 ± 4.1 kg/m(2) and 8.3 ± 2.2%, respectively. With respect to generally accepted ABC treatment goals, 35.2% of participants had HbA1c <7%; 35.5% had BP < 140/80 mmHg, and 45.1% had LDL-c < 100 mg/dl. The proportion of patients who met all three targets was only 5.4%. Logistic regression revealed that smoking (P=0.000), higher BMI (P=0.001) and insulin use (P=0.000) were statistically significant predictors of failing to meet ABC targets. CONCLUSION: The percentage of Chinese patients with type 2 diabetes who met recommended targets for HbA1c , BP and LDL-c in 2010 was low. Smoking, higher BMI and insulin use were the strongest determinants of failing to meet ABC targets.