社区糖尿病患者体重指数、遵医行为、服药依从性、血糖控制现状与管理策略

Body Mass Index, Medical Compliance Behavior, Medication Adherence, and Glycemic Control in Community-Dwelling Patients with Diabetes: Current Status and Management Strategies

摘要: 目的：探讨天津市武清区下朱庄社区2型糖尿病患者(T2DM)的体重指数、遵医行为、服药依从性及血糖控制情况来干预糖尿病的发生和发展。方法：通过问卷调查方式对天津市武清区下朱庄卫生院辖区内T2DM患者进行调查，收集患者体重、血压、血糖的测量以及计算体重指数、遵医行为、服药依从性、血压值及血糖控制情况。结果：347例糖尿病患者，平均年龄59.02 ± 11.8岁，其中男性138人，女性209人。根据最近一次血糖测量结果，发现血糖控制不满意为140人(40.35%)，血糖控制满意为207人(59.65%)。347例糖尿病患者中，29例患者血压正常(8.36%)，血压正常高值者318人(91.64%)。体重指数异常总例数239人(68.88%)，超重171人(49.28%)，肥胖68人(19.6%)。吸烟79人(22.77%)，饮酒45人(12.97%)，主食量达标97人(27.95%)，主食量不达标250人(72.05%)，不运动113人(32.56%)，运动小于5次/周121人(34.87%)，运动不达标人数为234人(67.44%)。遵医行为良好25人(7.2%)，遵医行为一般272人(78.39%)，遵医行为差50人(14.41%)。规律服药204人(58.79%)，间断服药116人(33.43%)，不服药27人(7.78%)。结论：天津市武清区下朱庄社区2型糖尿病患者血糖控制达标率接近60%，但存在体重指数异常占比高、主食摄入与运动达标率低、遵医行为及服药依从性不足等问题，需针对性强化健康管理干预以改善患者预后。

Abstract: Objective: To investigate the body mass index (BMI), compliance behavior, medication adherence, and glycemic control status among patients with type 2 diabetes mellitus (T2DM) in the Xiazhuzhuang community of Wuqing District, Tianjin, and to explore intervention strategies for the prevention and progression of diabetes. Methods: A questionnaire survey was conducted among T2DM patients under the jurisdiction of Xiazhuzhuang Community Health Center in Wuqing District, Tianjin. Data were collected regarding anthropometric measurements (weight, blood pressure, blood glucose), BMI calculation, compliance behavior, medication adherence, and the status of blood pressure and glycemic control. Results: A total of 347 diabetic patients were enrolled, with a mean age of 59.02 ± 11.8 years; 138 were male and 209 were female. Based on the most recent blood glucose measurements, 140 patients (40.35%) had unsatisfactory glycemic control, while 207 patients (59.65%) achieved satisfactory control. Regarding blood pressure, only 29 patients (8.36%) had normal levels, whereas 318 patients (91.64%) were in the high-normal range. Abnormal BMI was observed in 239 patients (68.88%), including 171 overweight cases (49.28%) and 68 obese cases (19.60%). Lifestyle factors revealed that 79 patients (22.77%) were smokers, 45 (12.97%) consumed alcohol, 97 (27.95%) met the staple food intake standard, while 250 (72.05%) did not. Physical inactivity was reported in 113 patients (32.56%), and 121 patients (34.87%) exercised less than five times per week, resulting in an overall non-compliance rate of 67.44% for physical activity. Compliance behavior was categorized as good in 25 patients (7.2%), moderate in 272 patients (78.39%), and poor in 50 patients (14.41%). Regarding medication adherence, 204 patients (58.79%) took medications regularly, 116 (33.43%) took them intermittently, and 27 (7.78%) were non-adherent. Conclusion: The glycemic control rate among T2DM patients in the Xiazhuzhuang community of Wuqing District is nearly 60%. However, significant challenges remain, including a high prevalence of abnormal BMI, low compliance rates regarding staple food intake and physical activity, suboptimal compliance behavior, and insufficient medication adherence. Targeted health management interventions are urgently needed to improve patient prognosis.