| Objective To investigate the association of familial history(FH)of diabetes with the glycaemic control status of patients with type 2 diabetes mellitus(T2DM) Method A cross-sectional study using stratified cluster sampling was conducted with 20053 diabetic patients in Jiangsu,China.Using combination of fasting plasma glucose(FPG:mmol/L)and haemoglobin A1c(HbAlc:%)to assess glycaemic status in T2DM patients,and the status of glycaemic control was defined as "good","common" and "poor" when the criteria of HbA lc<7%and FPG<7mmol/L were both met,when either criterion was met,and when neither was met,respectively.Multiple logistic regression and stratified analyses were used to assess odds ratio(OR)and corresponding 95%confidence intervals(CI).Results Excluding 61 subjects with glycemic index missing and 917 subjects with information of FH missing.In total,19075 subjects were enrolled in analysis,21.3%of the T2DM patients reported a FH of diabetes.Patients with a FH of diabetes showed a higher risk of poor glycaemic control(59.7%)than those without a diabetic FH(49.8%),with OR(95%CI)of 1.366(1.225-1.524),P<0.001.Glycaemic control status did not significantly differ between the T2D patients with parental FH and those with sibling FH,OR(95%CI)=1.157(0.830-1.612),P=0.389.Compared with patients with paternal FH,Patients with maternal FH had a higher risk of poor glycaemic control with OR(95%CI)=1.611(1.106-2.347),P=0.013.The results of stratified analyses showed that compared with patients without FH,patients with a FH of diabetes was significantly associated with poor glycaemic control in both stratus of age,gender,body mass index(BMI),antidiabetic treatment and energy metabolism,as well as among T2D patients with a low education level,all of P value<0.05.In the<60 years old group,overweight,and low level of physical activity groups,patients with a maternal history of diabetes showed a higher risk of poor glycaemic control than those without a FH,and moreover,in every stratus of antidiabetic treatment,maternal history of diabetes was associated with poor glycaemic control and all of P value<0.05.In contrast,no significant association was found between paternal history of diabetes and poor glycaemic control in every stratus.Conclusion A diabetic FH is associated with poor glycaemic control independently.No difference of glycaemic control was found between patients with parental FH and patients with siblings FH.Patients with maternal FH had a higher risk of poor glycaemic control compared with patients with paternal FH.Maternal FH of diabetes was significantly associated with glycaemic control among patients of age bellow 60 years,overweight and with low level of physical activity.T2DM patients with FH are at high risk of poor glycaemic control and appropriate measures should be taken to help these patients to improve their glycaemic control.Objective To investigate the association between age at menarche(AM),menopause status,age at natural menopause(ANM)and glycaemic control in female patients with type 2 diabetes mellitus(T2DM),and to provide scientific basis for screening for T2DM women with poor glycaemic control.Methods On the basis of program of comprehensive intervention and application study in community in Jiangsu province,we selected women with T2DM who met the inclusion criteria as this research subject,and analyzed the association between menstrual history and glycaemic control with different evaluating index including fasting plasma glucose(FPG),hemoglobin Alc(HbAlc)and FPG&HbAlc.FPG was categorized into two groups as<7 mmol/L and ?7mmol/L;HbAlc was categorized into two groups as<7%and ?7%;and combined assessment was categorized into 3 groups as good(both FPG and HbAlc<7),common(either FPG or HbAlc<7)and poor(neither FPG nor HbAlc<7).Logistic regression was used with three different models:model 1 adjusting for age and body mass index(BMI);model 2 adjusting for age,BMI,education,duration of diabetes,smoking,drinking and antidiabetic treatment;and model 3 adjusting for variables in model 2 plus familial history of diabetes and physical activity.Odds ratio(OR)and 95%confidence interval(CI)were calculated for analysis.Results There were 8344 women with T2DM in this study and 1195(14.32%)were premenopausal women and 7149(85.68%)were postmenopausal women;the average age of the total women was 65.59 years;the average AM was 16.65 years;the average ANM in postmenopausal women was 49.53 years.The results of logistic regression showed that,after adjusting for age and BMI,there were significant association between the risk of FPG ?7 mmol/L in female patients and the increasing of AM and OR(95%CI)was 0.965(0.944-0.986),P=0.001;significant association was also found between the risk of HbAlc ?7%and the increasing of AM and OR(95%CI)was 0.978(0.958-0.999),P=0.040;with the combined assessment,the risk of poor glycemic control in female patients decreased along with the increasing of AM and OR(95%CI)was 0.962(0.939-0.986),P=0.002.However,after adjusting for other covariates besides age and BMI,significant association was not found between AM and glycaemic control in model 2 and model 3.The results in model 3 logistic regression indicated that:according to FPG index,female patients with ANM<45 years had a higher risk of FPG ?7 mmol/L compared with women with ANM 45-55 years,however the association did not reach statistically significant with OR(95%CI)1.229(0.995-1.517),P=0.055,but female patients with ANM>55 years had a significantly higher risk of FPG ?7 mmol/Lwith OR(95%CI)1.407(1.089-1.817),P=0.009.According to HbAlc index,female patients with ANM<45 years and women with ANM>55 years both had a significantly higher risk of HbAlc?7%compared with women with ANM 45-55 years with OR(95%CI)1.220(1.000-1.488)and 1.306(1.025-1.664),P value was 0.005 and 0.031 respectively.When the glycaemic control of T2DM women was assessed with combinational index,the results showed that compared with female patients with ANM 45-55 years,female patients with ANM<45 years and women with ANM>55 years had a higher risk of poor glycaemic control with OR(95%CI)1.286(1.009-1.639)and 1.565(1.157-2.116)respectively compared with women with ANM 45-55 years. Conclusion Age at menarche was significantly associated with glycaemic control independent of age and BMI among T2DM women and age at natural menopause was significantly associated with glycaemic control independent of age,BMI,education,duration of diabetes,smoking,drinking,antidiabetic treatment,familial history of diabetes and physical activity.Strengthening glycaemic monitoring should be done among T2DM women with early age at menarche or early age at natural menopause or delayed age at natural menopause. |
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