| Objectives:The aim of study was to analyze the prevalence,awareness,treatment,control and self-management of diabetes among old adults,and to assess the disease economic risk of old diabetics in rural areas of Midu county,Yunnan province.Providing theoretic evidences of management and prevention of elderly diabetics for local medical institutions by analyzing the influencing factors of prevalence and disease economic risk.Methods:A multi-stage stratified random sampling method was used to carry out on-site questionnaire survey and physical examination among 1603 adults aged?60 years.The basic demographic information,diabetes prevalence,data of self-management behaviors of the rural elderly and relative indicators of the assessment of disease economic risk were investigated and collected by questionnaire.In addition,testing and recording the value of fasting blood glucose,height,weight,and waist circumference.Data entry with Epidata3.0 and SPSS22.0 is used to achieve the statistical analysis.Chi-square test is used to compare different rates or constituent ratios,and variance analysis is used to compare means.The analysis of relative influencing factors of diabetic prevalence,catastrophic health expenditure(CHE)and poverty due to illness by logistic regression,a=0.05.Results:The overall prevalence,awareness,treatment,and control of diabetes among elderly were 10.1%,56.2%,75.8%,and 37.4%,respectively.The elderly with higher average annual income had higher prevalence of diabetes(P<0.05).The awareness of female was higher than male(P<0.05).There was no significance in the difference of control and treatment rates among patients with different demographic characteristics.According to the result of logistic regression,obesity(OR=1.952,95%CI:1.162?3.277),central obesity(OR=1.630,95%CI:1.126?2.359),having hypertension(OR=1.598,95%CI:1.115?2.290),and family history of diabetes(OR=2.329,95%CI:1.391?3.898)were risk influencing factors of diabetic prevalence for elderly of rural areas in Midu county(P<0.05).The rates of self-monitoring blood glucose of diabetics,taking drugs according to the doctors' orders,and taking hypoglycemic measures who aged over 60 years old were 44.0%,80.2%,98.9%,in Midu county,Yunnan province,respectively.In the last two weeks,the prevalence of taking measures to decrease blood glucose such as controlling weight or losing weight,controlling diet,increasing exercise and smoking cessation were 62.6%,90.1%,60.4%and 12.1%,respectively.Han majority residents and whose houses with toilet had higher rates of self-monitoring blood glucose(P<0.05).The rate of taking medicine according to the doctor's advice in elderly diabetics decreased with age(P<0.05).Patients of higher education had a higher rate of taking medicine prescribed by doctors(P<0.05).Diabetics who didn't live lonely and who had toilet in house had higher rates of weight control(P<0.05).Han majority and female patients had high diet control rates(P<0.05).The old diabetics of poor accessibility of medical services had a higher rate of increasing exercise(P<0.05).The rate of smoking cessation of male patients was higher than female(P<0.05).The disease economic risk of elderly diabetics in rural areas of Midu county of Yunnan province was 1.13 times higher than the observed population(RR=1.13),and it was 1.19 times after adjusting for income factor(ARR=1.19).The incidence of CHE and poverty due to illness were 16.5%and 9.9%in elderly diabetic families of Midu county in Yunnan province,respectively.Higher disease economic risk was faced by the patients with poor accessibility of medical services,lower per capita annual income,house without toilet and poor households.Families with lower annual per capita income and poor households had high incidence of poverty due to illness(P<0.05).The result of logistic regression showed that annual income per capita,housing structure,and family members had diabetes or not were influencing factors of CHE and poverty caused by disease in rural families of Midu county.The average annual income more than 5000 yuan and housing structure is brick-wood or brick-concrete were protective factors for CHE or poverty due to illness(OR<1,P<0.05).Family with diabetics was risk factors which result in CHE or poverty caused by illness for rural elderly families.Conclusions:The prevalence of diabetes among elderly in rural areas of Midu county was high.The findings also indicate that the rates of awareness and control were relatively low,and the self-management of diabetes in a low level.The incidence of CHE and poverty due to illness were relatively high.Diabetic patients and families were faced a greater economic risk of disease.In the future,health knowledge education and prevention publicity of diabetes should be strengthened,especially the elderly population with obesity,central obesity,hypertension and family history of diabetes,in the work of prevention and treatment of diabetes in rural areas of Midu county.Strengthening the work of screening diabetes and the management of the treatment of the patients is to improve the awareness and control rate of diabetes in the elderly population,especially in the male.For the diabetics with minority nation,poor economic condition,and low education,developing the education of treatment compliance is to improve the rate of self-monitoring blood glucose and taking medicine.Self-management education should be enhanced for patients who live lonely and with poor economic condition.Patients with minority nation and male should be improved the awareness of diet control.Combining the economic and medical service availability of the patients,the medical services and financial support of the diabetic patients with low income and poor access to medical services,especially the poor households,were moderately increased. |
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