Clinical Analysis Of 550 Cases Of Type 2 Diabetes And Their Diabetic Complications In Guangdong Foshan

Objective To investigate the treatment of type 2 diabetes and the incidence of type 2 diabetes and diabetic complications in community hospitals, and to improve the diagnosis and therapy of diabetes and pave the way for the prevention of diabetes and diabetic complications in community hospital. Methods 1.Acquirement of clinical data: To establish the investigation items and the questionnaire of therapy of type 2 diabetes in-patients by epidemiological method. Retrospective analysis was based on the clinical and laboratory data of 550 cases of type 2 diabetes in-patients in Foshan community hospital from May, 2005 to July, 2007. 2. Correlation analysis of influence factors: To find out the therapy of type 2 diabetes in community hospital and investigate the significance of the different clinical parameters in prevention, therapy and postponement of diabetes and diabetic complications, retrospective Analysis of patients' clinical and laboratory data and frequency analysis and two sample T test about the diabetic complications distributions in different course of disease and age were conducted by SPSS.Results We investigated 550 cases of type 2 diabetes in-patients in Foshan community hospital from May, 2005 to July, 2007, including 236 male patients(42.9%) and 314 female patients(57.1%). The ages differed from 22 to 89years old, 23 patients were below 40 years old(4.2%), 219 patients were from 40 to 60 years old(39.8%) and 308 patients were above 60 years old(56.0%). The average age was 61.20±11.00. The disease courses differed from 0 to 30 years, including 137 cases in which the disease courses were less than 1 year(24.9%), 230 cases in which the disease courses were from 1 to 5 years(41.8%),and 147 cases in which the disease courses were from 5 to 10 years(26.7%) and 46 cases in which the disease courses were above 10 years(8.4%). The average disease course was 4.90±4.50 years. The incidence of diabetic complications is 89.82% (494/550) and the sequence incidences of diabetic complications from high to low are brain vessel disease (59.6%) , hypertension(45.5%), hyperlipoidemia(41.3%), coronary heart disease(27.3%), fattyliver(19.3%), peripheral neuritis(18.5%), diabetic nephropathy(17.8%). Along with the extension of the disease course, the incidence of hypertension, coronary heart disease, brain vessel disease and peripheral neuritis increases significantly(P＜0.01). The incidence of coronary heart disease, hypertension and brain vessel disease increases significantly with aging(P＜0.01). The incidence of hyperlipoidemia is highest in patients younger than 40 years old(P＜0.01), and lowest in patients older than 60 years old(P＜0.01).Referring to IDF WPR's 2005 "Type 2 Diabetes Pratical Targets and Treatments" guidelines, we analyzed the controlled levels of fasting blood glucose, glycated haemoglobin, total cholesterol, trig-lycerides, high density lipoprotein and low density lipoprotein and investigated the basic therapeutic measures. There were 460 patients had tested their glycated haemoglobin and 90 patients(about 16%) hadn't. In 164 patients(35.7%), control of glycated haemoglobin was ideal. In 113 patients(24.6%), control of glycated haemoglobin was good (6.5%/～7.5%) . In 183 patients(59.8%), control of glycated haemoglobin was not good(＞7.5%). 59.8% patients didn't have a good control of fasting blood glucose. The standardized rate of the control of total cholesterol, trig-lycerides and low density lipoprotein was 15.6,44.4% and 46.4% respectively. According to basic therapeutic measures investigation, we found 77.82 per cent patients took dietetic therapy, 42.55 per cent patients took exercise therapy, 79.6 per cent patients took oral hypoglycemic therapy and 20.4 per cent patients took insulin therapy.Conclusions: After the SPSS analysis of the data of 550 cases of type 2 diabetes in-patients in Foshan community hospital from May, 2005 to July, 2007, we can draw the following conclusions:1. Distribution of type 2 diabetes patients increase with age. Female patients are more than male. Distribution of cardiovascular complication and high blood pressure increase with age and course of disease. Distribution of hyperlipoidemia, adiposis hepatica, cerebral vascular complication increase with age. Distribution of peripheral neuritis increase with course of diseases. While distribution of diabetic nephropathy is not associated with age and course of diseases. Courses of diabetes were short whilethe complication occurred in early phase of diabetes. (patients whose courses of disease is below 5 years account for 66.7% ) Rates of complication are high (there are 2.31 complication on average). Such phenomenon indicated that the task to prevent complication of T2DM is arduous in community hospital.2. Control of HbAlc, total cholesterol, triglycerides, low density lilpoprotein and high density lipoprotein is not ideal. Dietetic therapy and exercise therapy were not adopted in most patients and Insulin was not widely used, as a result, patients got poor control on every aspect. Thus, in order to prevent the complication of T2DM, doctors of community hospital should cure patients according to the clinical guide.