Q Deng1, M Zhang, Z J Huang, Y C Li, L M Wang. 1. National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Abstract
Objective: To investigate the community-based management of diabetes patients aged ≥35 years in China. Methods: The subjects from 2013-2014 Chronic Non-communicable Disease and Risk Factor Surveillance in China were used in this study, those who were aged ≥35 years and diagnosed by doctors in hospitals at community level or above were selected through clustering sampling. Questionnaire was used to collect the data of subjects' general information, health status, the treatment and the control of blood glucose. Blood samples were taken from the subjects to detect the fasting blood glucose level and blood glucose level at 2 hours after oral administration of glucosum anhydricum. The subjects were weighted according to complex sampling scheme to calculated the different rates and 95%CI. The Rao-scott χ2 test was performed to test the differences in rates between the subgroups. Results: The survey indicated that among the 10 056 diabetes patients aged ≥35 years and diagnosed with diabetes, 4 609 received management service in communities. After being weighted, the management rate of diabetes patients was 45.0% (95% CI: 40.8%-49.2%). Females (46.9%, 95% CI: 42.8%-51.0%) had higher management rate than males (43.0%, 95% CI: 38.1%-47.9%). The management rate was higher in rural area (50.4%, 95%CI: 46.3%-54.5%) than in urban area (41.6%, 95%CI: 35.5%-47.6%). There was a significant age specific difference in the proportion of patients receiving management services (χ2=21.0, P<0.01), the rate of management was highest in the patients aged ≥65 years (49.2%, 95%CI: 43.6%-54.7%), but lowest in the patients aged 35-44 years (35.2%, 95% CI: 27.9%-42.4%). The overall standardized management rate of diabetes patients in communities was 16.7% (95% CI: 13.7%-19.7%). The proportion of urban patients receiving standardized management service (19.7%, 95% CI: 15.3%-24.1%) was higher than that of rural patients (12.8%, 95% CI: 9.8%-15.8%). The overall treatment rate of diabetes patients in communities was 95.8% (95%CI: 94.8%-96.9%). The treatment rate was higher in females (97.0%, 95%CI: 96.0%-98.0%) than that in males (94.5%, 95%CI: 92.7%-96.4%). The control rate of blood glucose in diabetes patients receiving management in communities was 34.6% (95%CI: 31.5%-37.6%), and the highest blood glucose control rate was in the patients aged ≥65 years (38.2%, 95%CI: 33.4%-43.0%), while the lowest blood glucose control rate was in the patients aged 45-54 years (34.4%, 95% CI: 26.7%-42.0%). Conclusions: Both the standardized management rate and blood glucose control rate were low in the diabetes patients aged ≥35 years in China. It is necessary to strengthen the allocation of medical resources in communities and standardized diabetes management.
Objective: To investigate the community-based management of diabetespatients aged ≥35 years in China. Methods: The subjects from 2013-2014 Chronic Non-communicable Disease and Risk Factor Surveillance in China were used in this study, those who were aged ≥35 years and diagnosed by doctors in hospitals at community level or above were selected through clustering sampling. Questionnaire was used to collect the data of subjects' general information, health status, the treatment and the control of blood glucose. Blood samples were taken from the subjects to detect the fasting blood glucose level and blood glucose level at 2 hours after oral administration of glucosum anhydricum. The subjects were weighted according to complex sampling scheme to calculated the different rates and 95%CI. The Rao-scott χ2 test was performed to test the differences in rates between the subgroups. Results: The survey indicated that among the 10 056 diabetespatients aged ≥35 years and diagnosed with diabetes, 4 609 received management service in communities. After being weighted, the management rate of diabetespatients was 45.0% (95% CI: 40.8%-49.2%). Females (46.9%, 95% CI: 42.8%-51.0%) had higher management rate than males (43.0%, 95% CI: 38.1%-47.9%). The management rate was higher in rural area (50.4%, 95%CI: 46.3%-54.5%) than in urban area (41.6%, 95%CI: 35.5%-47.6%). There was a significant age specific difference in the proportion of patients receiving management services (χ2=21.0, P<0.01), the rate of management was highest in the patients aged ≥65 years (49.2%, 95%CI: 43.6%-54.7%), but lowest in the patients aged 35-44 years (35.2%, 95% CI: 27.9%-42.4%). The overall standardized management rate of diabetespatients in communities was 16.7% (95% CI: 13.7%-19.7%). The proportion of urban patients receiving standardized management service (19.7%, 95% CI: 15.3%-24.1%) was higher than that of rural patients (12.8%, 95% CI: 9.8%-15.8%). The overall treatment rate of diabetespatients in communities was 95.8% (95%CI: 94.8%-96.9%). The treatment rate was higher in females (97.0%, 95%CI: 96.0%-98.0%) than that in males (94.5%, 95%CI: 92.7%-96.4%). The control rate of blood glucose in diabetespatients receiving management in communities was 34.6% (95%CI: 31.5%-37.6%), and the highest blood glucose control rate was in the patients aged ≥65 years (38.2%, 95%CI: 33.4%-43.0%), while the lowest blood glucose control rate was in the patients aged 45-54 years (34.4%, 95% CI: 26.7%-42.0%). Conclusions: Both the standardized management rate and blood glucose control rate were low in the diabetespatients aged ≥35 years in China. It is necessary to strengthen the allocation of medical resources in communities and standardized diabetes management.