| OBJECTIVES：Diabetes Mellitus (DM) is characterized by metabolic disorders of chronichyperglycemia induced by a variety of causes, and is the third serious chronic diseasedamages human health after tumor and cardiovascular diseases. Type2Diabetes Mellitus(T2DM) mainly due to insulin resistance accompanied by relative deficiency of insulin, orinsufficient insulin secretion with or without insulin resistance, taking up90%to95%ofdiabetes. In recent years, diabetes is widely popular in the whole world, whether indeveloped or developing countries, and the incidence rate of diabetes is increasing rapidly.In China, as aging of population, improvement of people’s living standard andmodification of lifestyle, the prevalence of senile diabetes increased gradually. The resultof sample survey of31provinces of China in2001showed that the prevalence rate ofdiabetes was6.8%among the seniors above60years old, and the morbidity rate rose to20.4%in2008according to14provinces investigation. Diabetes has become one of theleading causes of disability and death among senior patients. Therefore, to strengthen theeducation and management of senile diabetes is essential to improve the quality of life inelder residents and to prolong their life.The present study aims to learn about the previous diagnosis rate of the type2diabetes among the seniors above65years old living in Tangqiao Community, PudongDistrict of Shanghai city, and to acquire the indexes of blood lipids, liver and kidneyfunction, related risk factors of type2diabetes, in order to provide scientific basis for thestrategy of prevention and management of senile type2diabetes of this area.METHODS:According to project requirement of basic public health services from the Ministry ofHealth, free physical examinations were conducted for older people above65ys fromTangqiao streets by the Health Service Center of Tangqiao community. There are12,227 seniors over the age of65in Tangqiao street.By randomized cluster sampling，4219peoplewere enrolled the study eventually. The research contents included surveys of lifestyle (diet,exercise, drinking, smoking), physical examinations（height, weight, waist circumference,hip circumference and blood pressure) and laboratory tests (fasting venous blood sugar,liver and kidney function, blood lipids), and the prevalence of diabetes as well as its riskfactors were analyzed for those residents in this community.RESULTS:1. The previous diagnosis rate of T2DM in the research objects was19.1%,respectively. In males, the previous diagnosis rate of T2DM was17.6%, which in femaleswas20.5%.In the process of examination, found that603people of fasting plasmaglucose abnormalities, accounting for14.3%of the total population,so the actualprevalence of elderly T2DM may be higher than19.1%.2. The main clinical symptoms of elderly patients with T2DM are polydipsia, polyuria,fatigue, blurred vision, numbness, loss of body weight, etc.3.Comparing the related physiological and biochemical indexes between elderlypatients with or without type2diabetes (t-test and chi square test), the results showed thatthe average levels of systolic blood pressure, BMI, WHR, fasting blood sugar, triglyceride,low density lipoprotein cholesterol and serum urea nitrogen, were all significantly higherin senile T2DM patients than those of patients without diabetes (P <0.05). In elderlypatients with T2DM，the population proportion of abnormal indexes，which are fastingblood sugar triglyceride, low density lipoprotein cholesterol，in fasting plasma glucose,triglyceride, low density lipoprotein cholesterol and creatinine is higher than those ofpatients without diabetes, the results have statistical significance.4. In patients with complete data collected to be able to calculate GFR levels,45.4%of them showed normal renal function（CKD in1period）；47.2%with CKD in2period；6.9%with CKD in3period；0.3%with CKD in4period and another0.2%has reached5period of CKD.The average levels of GFR(t test) and the one according to the analysis ofage stratification have no statistical differences in elderly T2DM patients compared withnon-diabetics (P>0.05).5. The relationships between type2diabetes incidence with obesity,physical exercise,smoking and drinking were analyzed by using the multiple factor Logistic regressionanalysis. In which, we found that abdominal obesity and lacking physical exercise were the independent risk factors for occurrence of diabetes.CONCLUSIONS:1. The prevalence rate of type2diabetes had reached a relatively high level inelderly residents living in TangQiao community of Shanghai.2. It is also necessary to enhance the management of blood lipids and blood pressurein the process of intervention for type2diabetes.3. Community physicians should pay close attention to the progress of the kidneycomplications in senile diabetics.4. The most effective strategies in diabetes management include positive lifestylechanges, physical activity, weight control, quit smoking and limit alcohol. |
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