Glycemic Control and Medication Compliance of Type 2 Diabetes in Community Management System in Shanghai

Objective To assess the status and trends of treatment of type 2 diabetes mellitus (T2DM) and glycemic control in Shanghai communities.

Methods In 2009 and 2013, 1 710 and 2 800 patients with T2DM were randomly selected from the Shanghai community diabetes management system respectively. Data on demographic information, treatment regimen, blood glucose le vels were collected by questionnaire interviews, physical examinations, and laboratory tests.

Results A total of 1 629 and 2 741 valid questionnaires were returned. The control rate (prevalence rate of patients meeting the control target of HbA1c < 7%) rose from 43.7% in 2009 to 46.8% in 2013, and the rate of treatment compliance increased from 88.1% to 94.8%. Sulfonylureas (53.3%), despite of a significant decrease in its use (P < 0.05), remained to be the mainstay of oral anti-diabetic treatment, followed by metformin (40.1%) and α-glycosidase inhibitors (15.8%), and the use of metformin, α-glycosidase inhibitors, and insulin had no changes. Patients receiving insulin or combination therapy had worse glucose control rates than those having oral hypoglycemic agents alone or single medicine therapy.

Conclusion Community administration can significantly improve the treatment compliance and glucose control of patients with T2DM. However, community health professionals are comparatively unfamiliar with the scientific usage of hypoglycemic drugs as well as national and international diabetes treatment principles. Thus, timely preparing policies is needed to strengthen technical support in diabetes control for community hospitals.