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Article(id=1241036333079130517, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202410415, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729785600000, receivedDateStr=2024-10-25, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815719145, onlineDateStr=2026-03-18, pubDate=1757433600000, pubDateStr=2025-09-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815719145, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815719145, creator=13701087609, updateTime=1773815719145, updator=13701087609, issue=Issue{id=1241036327177744706, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='17', pageStart='3073', pageEnd='3264', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815717738, creator=13701087609, updateTime=1773840080282, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241138511152206262, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241138511152206263, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241036327177744706, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3172, endPage=3177, ext={EN=ArticleExt(id=1241036335943840235, articleId=1241036333079130517, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=A comparative study of diabetes prevalence and self-management among elderly Dai, Hani, and Bai in rural Yunnan Province, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the prevalence of diabetes and self-management behaviors among elderly Dai, Hani, and Bai in rural areas of Yunnan.

Methods

A multi-stage stratified random sampling approach was used to conduct a questionnaire survey and blood glucose measurement on 4 229 rural residents aged ≥60 years from the Dai, Hani, and Bai ethnic groups in Yunnan.

Results

The age-standardized prevalence rate of diabetes among elderly individuals in the surveyed areas was 7.6%for the Dai ethnic group, 5.0% for the Hani ethnic group, and 16.0% for the Bai ethnic group. The differences in diabetes prevalence among the three ethnic groups were statistically significant (χ2=105.856, P<0.001), with the Bai group having the highest prevalence, followed by the Dai and then the Hani. The differences in prevalence among the three ethnic groups within each age group were all statistically significant (all P<0.01). Among diabetic patients, the rates of adhering to taking prescribed medications, self-monitoring blood glucose, and taking at least one measure to control blood glucose in the past two weeks were 94.7%, 42.1%, and 100.0% for the Dai ethnic group, 79.4%, 26.5%, and 94.1% for the Hani ethnic group, and 98.2%, 57.6%,and 98.8% for the Bai ethnic group, respectively. Across all three ethnic groups, dietary control was the most commonly adopted measure for managing blood glucose in the two weeks prior to the survey. The overall blood glucose control rate among the three ethnic groups was 47.7%. The blood glucose control rates among elderly diabetic patients were 50.9% for the Dai, 58.8% for the Hani, and 44.2% for the Bai ethnic groups, with no statistically significant differences observed among the groups (P>0.05).

Conclusion

Significant ethnic differences in diabetes prevalence and self-management behaviors are observed among elderly individuals from the Dai, Hani, and Bai ethnic groups in rural Yunnan. Targeted health interventions and management strategies should be developed to address ethnic backgrounds and health needs of these populations.

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目的

分析云南傣族、哈尼族和白族农村老年人糖尿病的患病及自我管理现状。

方法

采用多阶段分层随机抽样法，抽取4 229名≥60岁云南傣族、哈尼族和白族农村老年人开展问卷调查和血糖测量。

结果

调查地区傣族、哈尼族和白族老年人糖尿病标化患病率分别为7.6%、5.0%和16.0%，三个民族间的糖尿病患病差异有统计意义（χ2=105.856，P<0.001）；白族居民的患病率最高，傣族次之，哈尼族最低；各年龄组中三个民族间的患病率差异均有统计意义（均P<0.01）。傣族老年糖尿病患者按医嘱服药率、自我监测血糖率和近两周采取至少一项降糖措施率分别为94.7%、42.1%和100.0%，哈尼族为79.4%、26.5%和94.1%，白族为98.2%、57.6%和98.8%；其中三个民族老年糖尿病患者近两周采取的降糖措施中均是以采取饮食控制率最高。三个民族整体的血糖控制率为47.7%，傣族、哈尼族和白族老年糖尿病患者的血糖控制率分别为50.9%、58.8%和44.2%，民族间差异无统计学意义（P>0.05）。

结论

云南农村傣族、哈尼族和白族老年人糖尿病的患病率和和糖尿病患者的自我管理行为存在民族差异，应根据不同民族背景和健康需求，制定更具针对性的健康干预措施和管理方案。

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蔡乐，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=/Jrlw9qBHa6YXBLRqsHp9Q==, magXml=+78LeIIUApbuWAn8KQN4hw==, pdfUrl=null, pdf=3VxK5UN+zEvRAbXf8NBlWw==, pdfFileSize=611041, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=J7deHiElif7I8qfR1Ki/XA==, mapNumber=null, authorCompany=null, fund=null, authors=

刘杜丽（1999—），女，硕士在读，研究方向：流行病与卫生统计学

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刘杜丽（1999—），女，硕士在读，研究方向：流行病与卫生统计学

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刘杜丽（1999—），女，硕士在读，研究方向：流行病与卫生统计学

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Study on the willingness to quit smoking and its influencing factors among current smokers in rural areas in China[J].Chinese Journal of Epidemiology, 2022, 43(12): 1887-1892.(In Chinese), articleTitle=Study on the willingness to quit smoking and its influencing factors among current smokers in rural areas in China, refAbstract=null)], funds=[Fund(id=1241139378379084690, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, awardId=72064026, language=CN, fundingSource=国家自然科学基金(72064026), fundOrder=null, country=null), Fund(id=1241139378479747993, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, awardId=202401AY070001-027, language=CN, fundingSource=云南省科技厅-昆明医科大学联合专项重点项目(202401AY070001-027), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241139370888057374, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, xref=null, ext=[AuthorCompanyExt(id=1241139370896445983, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, companyId=1241139370888057374, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China), AuthorCompanyExt(id=1241139370900640288, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, companyId=1241139370888057374, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=昆明医科大学公共卫生学院，云南 昆明 650500)])], figs=[ArticleFig(id=1241139377611526984, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=EN, label=Table 1, caption=

Demographic characteristics of Dai, Hani, and Bai ethnic older adults aged ≥60 years in rural Yunnan Province

, figureFileSmall=null, figureFileBig=null, tableContent=
特征傣族哈尼族白族合计
人数占比（%）人数占比（%）人数占比（%）人数占比（%）
性别
男69049.067348.066947.22 03248.0
女71951.072952.074952.82 19752.0
年龄（岁）
60～6436726.040929.222315.799923.6
65～6944631.742030.048133.91 34731.9
70～7432823.329521.033523.695822.7
≥7526819.027819.837926.792521.9
合计1 409100.01 402100.01 418100.04 229100.0
), ArticleFig(id=1241139377712190290, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=CN, label=表1, caption=

云南农村傣族、哈尼族和白族老年人基本人口学特征

, figureFileSmall=null, figureFileBig=null, tableContent=
特征傣族哈尼族白族合计
人数占比（%）人数占比（%）人数占比（%）人数占比（%）
性别
男69049.067348.066947.22 03248.0
女71951.072952.074952.82 19752.0
年龄（岁）
60～6436726.040929.222315.799923.6
65～6944631.742030.048133.91 34731.9
70～7432823.329521.033523.695822.7
≥7526819.027819.837926.792521.9
合计1 409100.01 402100.01 418100.04 229100.0
), ArticleFig(id=1241139377829630819, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=EN, label=Table 2, caption=

Prevalence of diabetes among Dai, Hani, and Bai ethnic older adults aged ≥60 years in rural Yunnan Province

, figureFileSmall=null, figureFileBig=null, tableContent=
特征傣族哈尼族白族
人数粗率（%）标化率（%）人数粗率（%）标化率（%）人数粗率（%）标化率（%）
性别
男497.1a7.1436.4b6.410215.214.9
女588.1a8.0283.83.912416.616.9
年龄（岁）
60～64246.5a6.4225.45.33616.116.5
65～69419.2a9.3225.25.35812.112.1
70～74267.9a7.8175.86.17020.920.9
≥75166.0a6.0103.63.96216.416.3
合计1077.6a7.6715.15.022615.916.0
), ArticleFig(id=1241139377968042859, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=CN, label=表2, caption=

云南农村傣族、哈尼族、白族老年人糖尿病患病情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征傣族哈尼族白族
人数粗率（%）标化率（%）人数粗率（%）标化率（%）人数粗率（%）标化率（%）
性别
男497.1a7.1436.4b6.410215.214.9
女588.1a8.0283.83.912416.616.9
年龄（岁）
60～64246.5a6.4225.45.33616.116.5
65～69419.2a9.3225.25.35812.112.1
70～74267.9a7.8175.86.17020.920.9
≥75166.0a6.0103.63.96216.416.3
合计1077.6a7.6715.15.022615.916.0
), ArticleFig(id=1241139378068706164, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=EN, label=Table 3, caption=

Prevalence of diabetes self-management among Dai, Hani, and Bai ethnic older adults aged ≥60 years in rural Yunnan Province［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征按医嘱服药自我检测血糖采取至少一项降糖措施采取降糖措施血糖控制达标
控制体重或减肥饮食控制增加锻炼戒烟
傣族
男21(91.3)10(43.5)23(100.0)a6(26.1)17(73.9)15(65.2)1(4.3)11(47.8)
女33(97.1)a14(41.2)a34(100.0)20(58.8)ab32(94.1)ab20(58.8)0(0.0)18(52.9)
合计54(94.7)a24(42.1)a57(100.0)26(45.6)a49(86.0)a35(61.4)1(1.8)29(50.9)
哈尼族
男15(88.2)7(41.2)15(88.2)2(11.8)13(76.5)8(47.1)1(5.9)11(64.7)
女12(70.6)2(11.8)17(100.0)3(17.6)10(58.8)8(47.1)0(0.0)9(52.9)
合计27(79.4)9(26.5)32(94.1)5(14.7)23(67.6)16(47.1)1(2.9)20(58.8)
白族
男68(97.1)39(55.7)69(98.6)6(8.6)61(87.1)43(61.4)b10(14.3)b32(45.7)
女94(98.9)56(58.9)94(98.9)7(7.4)88(92.6)40(42.1)0(0.0)41(43.2)
合计162(98.2)95(57.6)163(98.8)13(7.9)149(90.3)83(50.3)10(6.1)73(44.2)
三个民族
男104(94.5)56(50.9)107(97.3)14(12.7)91(82.7)66(60.0)b12(10.9)b54(49.1)
女139(95.2)72(49.3)145(99.3)30(20.5)130(89.0)68(46.6)0(0.0)68(46.6)
合计243(94.9)128(50.0)252(98.4)44(17.2)221(86.3)134(52.3)12(4.7)122(47.7)
), ArticleFig(id=1241139378173563776, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241036333079130517, language=CN, label=表3, caption=

云南农村傣族、哈尼族和白族老年人糖尿病自我管理现状比较［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
特征按医嘱服药自我检测血糖采取至少一项降糖措施采取降糖措施血糖控制达标
控制体重或减肥饮食控制增加锻炼戒烟
傣族
男21(91.3)10(43.5)23(100.0)a6(26.1)17(73.9)15(65.2)1(4.3)11(47.8)
女33(97.1)a14(41.2)a34(100.0)20(58.8)ab32(94.1)ab20(58.8)0(0.0)18(52.9)
合计54(94.7)a24(42.1)a57(100.0)26(45.6)a49(86.0)a35(61.4)1(1.8)29(50.9)
哈尼族
男15(88.2)7(41.2)15(88.2)2(11.8)13(76.5)8(47.1)1(5.9)11(64.7)
女12(70.6)2(11.8)17(100.0)3(17.6)10(58.8)8(47.1)0(0.0)9(52.9)
合计27(79.4)9(26.5)32(94.1)5(14.7)23(67.6)16(47.1)1(2.9)20(58.8)
白族
男68(97.1)39(55.7)69(98.6)6(8.6)61(87.1)43(61.4)b10(14.3)b32(45.7)
女94(98.9)56(58.9)94(98.9)7(7.4)88(92.6)40(42.1)0(0.0)41(43.2)
合计162(98.2)95(57.6)163(98.8)13(7.9)149(90.3)83(50.3)10(6.1)73(44.2)
三个民族
男104(94.5)56(50.9)107(97.3)14(12.7)91(82.7)66(60.0)b12(10.9)b54(49.1)
女139(95.2)72(49.3)145(99.3)30(20.5)130(89.0)68(46.6)0(0.0)68(46.6)
合计243(94.9)128(50.0)252(98.4)44(17.2)221(86.3)134(52.3)12(4.7)122(47.7)
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云南农村傣族、哈尼族和白族老年人糖尿病患病及自我管理现状的对比分析
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刘杜丽 , 余孜孜 , 阮春怡 , 李熙敏 , 保清柔 , 史睿敏 , 蔡乐
现代预防医学 | 基层卫生服务 2025,52(17): 3172-3177
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现代预防医学 | 基层卫生服务 2025, 52(17): 3172-3177
云南农村傣族、哈尼族和白族老年人糖尿病患病及自我管理现状的对比分析
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刘杜丽, 余孜孜, 阮春怡, 李熙敏, 保清柔, 史睿敏, 蔡乐
作者信息
  • 昆明医科大学公共卫生学院，云南 昆明 650500

    • 刘杜丽（1999—），女，硕士在读，研究方向：流行病与卫生统计学

通讯作者:

蔡乐，E-mail:
A comparative study of diabetes prevalence and self-management among elderly Dai, Hani, and Bai in rural Yunnan Province
Du-li LIU, Zi-zi YU, Chun-yi RUAN, Xi-min LI, Qing-rou BAO, Rui-min SHI, Le CAI
Affiliations
  • School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
出版时间: 2025-09-10 doi: 10.20043/j.cnki.MPM.202410415
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摘要
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目的

分析云南傣族、哈尼族和白族农村老年人糖尿病的患病及自我管理现状。

方法

采用多阶段分层随机抽样法，抽取4 229名≥60岁云南傣族、哈尼族和白族农村老年人开展问卷调查和血糖测量。

结果

调查地区傣族、哈尼族和白族老年人糖尿病标化患病率分别为7.6%、5.0%和16.0%，三个民族间的糖尿病患病差异有统计意义（χ2=105.856，P<0.001）；白族居民的患病率最高，傣族次之，哈尼族最低；各年龄组中三个民族间的患病率差异均有统计意义（均P<0.01）。傣族老年糖尿病患者按医嘱服药率、自我监测血糖率和近两周采取至少一项降糖措施率分别为94.7%、42.1%和100.0%，哈尼族为79.4%、26.5%和94.1%，白族为98.2%、57.6%和98.8%；其中三个民族老年糖尿病患者近两周采取的降糖措施中均是以采取饮食控制率最高。三个民族整体的血糖控制率为47.7%，傣族、哈尼族和白族老年糖尿病患者的血糖控制率分别为50.9%、58.8%和44.2%，民族间差异无统计学意义（P>0.05）。

结论

云南农村傣族、哈尼族和白族老年人糖尿病的患病率和和糖尿病患者的自我管理行为存在民族差异，应根据不同民族背景和健康需求，制定更具针对性的健康干预措施和管理方案。

糖尿病  /  患病率  /  自我管理  /  老年人  /  农村
Objective

To analyze the prevalence of diabetes and self-management behaviors among elderly Dai, Hani, and Bai in rural areas of Yunnan.

Methods

A multi-stage stratified random sampling approach was used to conduct a questionnaire survey and blood glucose measurement on 4 229 rural residents aged ≥60 years from the Dai, Hani, and Bai ethnic groups in Yunnan.

Results

The age-standardized prevalence rate of diabetes among elderly individuals in the surveyed areas was 7.6%for the Dai ethnic group, 5.0% for the Hani ethnic group, and 16.0% for the Bai ethnic group. The differences in diabetes prevalence among the three ethnic groups were statistically significant (χ2=105.856, P<0.001), with the Bai group having the highest prevalence, followed by the Dai and then the Hani. The differences in prevalence among the three ethnic groups within each age group were all statistically significant (all P<0.01). Among diabetic patients, the rates of adhering to taking prescribed medications, self-monitoring blood glucose, and taking at least one measure to control blood glucose in the past two weeks were 94.7%, 42.1%, and 100.0% for the Dai ethnic group, 79.4%, 26.5%, and 94.1% for the Hani ethnic group, and 98.2%, 57.6%,and 98.8% for the Bai ethnic group, respectively. Across all three ethnic groups, dietary control was the most commonly adopted measure for managing blood glucose in the two weeks prior to the survey. The overall blood glucose control rate among the three ethnic groups was 47.7%. The blood glucose control rates among elderly diabetic patients were 50.9% for the Dai, 58.8% for the Hani, and 44.2% for the Bai ethnic groups, with no statistically significant differences observed among the groups (P>0.05).

Conclusion

Significant ethnic differences in diabetes prevalence and self-management behaviors are observed among elderly individuals from the Dai, Hani, and Bai ethnic groups in rural Yunnan. Targeted health interventions and management strategies should be developed to address ethnic backgrounds and health needs of these populations.

Diabetes  /  Prevalence  /  Self-management  /  Elderly  /  Rural
刘杜丽, 余孜孜, 阮春怡, 李熙敏, 保清柔, 史睿敏, 蔡乐. 云南农村傣族、哈尼族和白族老年人糖尿病患病及自我管理现状的对比分析. 现代预防医学, 2025 , 52 (17) : 3172 -3177 . DOI: 10.20043/j.cnki.MPM.202410415
Du-li LIU, Zi-zi YU, Chun-yi RUAN, Xi-min LI, Qing-rou BAO, Rui-min SHI, Le CAI. A comparative study of diabetes prevalence and self-management among elderly Dai, Hani, and Bai in rural Yunnan Province[J]. Modern Preventive Medicine, 2025 , 52 (17) : 3172 -3177 . DOI: 10.20043/j.cnki.MPM.202410415
正文
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在社会经济飞速发展和人口老龄化的加剧的时代背景下，中国的糖尿病人口数正呈快速增长趋势，预计到2045年，我国糖尿病人数将达到1.744亿，其中老年人是糖尿病患病的主要群体[1-3]。糖尿病作为慢性病，病程长，致病因素复杂，管理不善将会导致严重的并发症，给患者、家庭乃至社会带来沉重负担[4]。通过坚持服药、监测血糖、改善生活方式等开展糖尿病的自我管理是患者维持正常血糖水平和预防相关并发症的有效手段和基石[5-6]。与城市地区相比，农村地区医疗资源相对匮乏、健康意识薄弱，导致患者的自我管理较差，糖尿病相关的健康问题显得更加突出[7-8]。云南地处中国西南边陲，经济发展相对落后，又为少数民族聚居的省份，由于各地文化、经济、生活习惯等因素的多样性，不同少数民族间的糖尿病患病及自我管理可能存在差异。然而，目前针对云南少数民族地区人群糖尿病的相关研究证据较为有限。本研究对傣族、哈尼族和白族三个云南独有少数民族农村地区≥60岁老年人开展现场调查，分析不同民族老年人糖尿病的患病情况及自我管理现状，旨在为今后当地制定和优化糖尿病的防控策略提供科学依据。
1　资料与方法
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1.1　资料来源
资料来源于2022—2023年在云南傣族、哈尼族和白族≥60岁农村老年人进行的问卷调查和体格检查资料。本研究已通过昆明医科大学伦理委员会审查和批准，项目批准号为KMMU2020MEC 030，开展调查前已获得调查对象的知情同意。
1.2　抽样方法
本研究采用多阶段分层随机抽样法。第一阶段，在云南省129个县中选择傣族、哈尼族和白族居民典型聚居的地区，各选取1个少数民族自治县（市），分别为景谷傣族彝族自治县、墨江哈尼族自治县和大理市。第二阶段，按其当地经济收入水平，将选取的少数民族自治县（市）的下辖乡/镇分为经济好和差两层，从每层随机抽取1个乡/镇，共计6个乡/镇。第三阶段，在所选乡/镇中采用比例概率抽样法(probability proportional to size, PPS)各抽取3个行政村，共计18个样本村。第四阶段，在所选样本村中，随机抽取在当地居住超过5年且≥60岁的傣族、哈尼族和白族老年居民开展调查。
1.3　现场调查
1.3.1　问卷调查
采用课题自制纸质问卷，由经专业培训的调查员开展一对一面访调查。问卷内容包括一般人口学特征（性别、年龄、民族等）、糖尿病患病情况和糖尿病自我管理情况。
1.3.2　现场体检
现场由昆明医科大学第一和第二附属医院的医生统一测量并记录调查对象的血糖，采集调查对象的无名指指尖末梢血，使用快速血糖仪（德国罗氏公司ACCU-CHEK）测定血糖值。
1.4　诊断标准和相关定义
1.4.1　诊断标准
糖尿病：（1）既往在乡镇及以上医疗机构被确诊为糖尿病；（2）未服用降糖药的情况下，空腹血糖≥7.0 mmol/L或餐后2h血糖≥11.1 mmol/L[3]。
1.4.2　相关定义
（1）糖尿病患病率：符合糖尿病诊断标准的人数占本次调查人数的比例。（2）自我监测血糖率：报告自我监测血糖的糖尿病患者数占调查前已确诊糖尿病患者数的比例。（3）按医嘱服药率：报告遵医嘱服药的糖尿病患者数占调查前已确诊糖尿病患者数的比例。（4）采取降糖措施率：本次调查前两周内，按照医生建议采取控制体重或减肥、控制饮食、增加锻炼、戒烟中的任一项措施的人数占调查前已确诊糖尿病患者数的比例。（5）血糖控制率：本次调查中患者通过治疗，空腹血糖<7.0 mmol/L或餐后2h血糖<10.0 mmol/L的患者人数占调查前已确诊糖尿病患者数的比例[9]。
1.5　统计分析
对所有问卷统一核查及编码，采用Epidata 3.1软件双录入、SPSS 24.0软件进行数据分析。以三个民族的合计人口作为标准人口，采用直接法进行率的标化；计数资料描述采用频数和构成比；不同特征组间率的比较采用χ2检验（等级资料采用趋势χ2检验），检验水准α=0.05。对三个民族间率的两两比较，采用Bonferroni法进行校正，调整检验水准为α除以比较次数，即α’=0.017。
2　结果
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2.1　调查人群基本情况
本次调查发放4 350份问卷，有效问卷4 229份，有效回收率为97.2%。其中，傣族、哈尼族和白族各发放1 450份，实际回收有效问卷分别为1 409（97.2%）、1 402（96.7%）和1 418份（97.8%）。
4 229名少数民族居民中，男性共2 032人（48.0%），其中傣族690人（49.0%）、哈尼族673人（48.0%）、白族669（47.2%）人；女性共2 197人（52.0%），其中傣族719人（51.0%）、哈尼族729人（52.0%）、白族749（52.8%）人。三个民族的性别构成差异无统计学意义（P>0.05）。傣族60～64岁、65～69岁、70～74岁和≥75岁组分别为367（26.0%）、446（31.7%）、328（23.3%）和268人（19.0%），哈尼族分别为409（29.2%）、420（30.0%）、295（21.0%）和278人（19.8%），白族分别为223（15.7%）、481（33.9%）、335（23.6%）和379人（26.7%）。三个民族的年龄构成差异有统计学意义（P<0.001）。见表1。
2.2　傣族、哈尼族和白族老年人糖尿病患病情况
调查地区白族、傣族、哈尼族老年人的糖尿病患病率分别为15.9%、7.6%、5.1%，年龄标化患病率分别为16.0%、7.6%和5.0%，三个民族间的糖尿病患病差异有统计意义（χ2= 105.856，P<0.001）；白族居民的患病率最高，傣族次之，哈尼族最低（傣族vs.哈尼族：χ2=7.162，傣族vs.白族：χ2=46.549，哈尼族vs.白族：χ2=87.312，均P<0.017）。按性别分层，民族间比较有统计学意义（男性：χ2=37.716，女性：χ2=71.835，均P<0.001），白族均显著高于傣族和哈尼族（均P<0.017）。在哈尼族居民当中，男性的糖尿病患病率高于女性（χ2=4.727，P=0.03），而傣族和白族无统计学意义（均P>0.05）。各年龄组中三个民族间的患病率差异均有统计意义（均P<0.01），其中白族均显著高于傣族和哈尼族（均P<0.017）。见表2。
2.3　傣族、哈尼族、白族老年糖尿病患者的自我管理现状
2.3.1　自我报告率
4 229名调查对象中，256人报告在调查前确诊为糖尿病患者，自我报告率为6.1%。
2.3.2　按医嘱服药率
调查对象整体的按医嘱服药率为94.9%。傣族、哈尼族和白族老年患者按医嘱服药率分别为94.7%、79.4%、98.2%，三个民族间按医嘱服药率差异存在统计学意义（χ2=20.610，P<0.001），哈尼族低于白族（P<0.017），其余比较无显著差异（P>0.017）。见表3。
2.3.3　自我监测血糖率
调查对象整体的自我监测血糖率为50.0%。傣族、哈尼族和白族老年患者自我监测血糖率分别为42.1%、26.5%、57.6%，三个民族的自我监测血糖率差异存在统计学意义（χ2=12.738，P=0.002），哈尼族低于白族（P<0.017），其余比较无显著差异（P>0.017）。见表3。
2.3.4　采取降糖措施率
98.4%的患者过去两周内采取了至少一项降糖措施，傣族、哈尼族和白族的采取降糖措施率分别为100.0%、94.1%和98.8%，三个民族间差异无统计学意义（P>0.05），但按性别分层，男性中不同民族间比较有显著差异（χ2=6.324，P=0.042）。
傣族、哈尼族和白族老年患者采取控制体重或减肥降糖的比率分别为45.6%、14.7%和7.9%，三个民族间差异有统计学意义（χ2=42.553，P<0.001），傣族高于哈尼族和白族（均P<0.017），后两者间无显著差异（P>0.017）。傣族女性采取该措施的比率高于同族男性（χ2=5.927，P=0.015），哈尼族和白族内部性别差异无统计学意义（P>0.05）。
傣族、哈尼族和白族老年患者控制饮食降糖的比率分别为86.0%、67.6%和90.3%，三个民族间差异有统计学意义（χ2=12.268，P=0.002），白族显著高于哈尼族（P<0.017），其余比较无显著差异（P>0.017）。傣族和白族女性控制饮食的比率高于同族男性（P<0.05），哈尼族内部性别差异无统计学意义（P>0.05）。
傣族、哈尼族和白族老年患者增加锻炼降糖的比率分别为61.4%、47.1%和50.3%，三个民族比较差异无统计学意义（P>0.05）。男性总体采取锻炼的比率显著高于女性（χ2=18.061，P<0.001），白族内部性别差异有统计学意义（χ2=6.020，P=0.014），傣族和哈尼族内部性别差异无统计学意义（P>0.05）。
傣族、哈尼族和白族老年患者采取戒烟降糖的比率分别为1.8%、2.9%和6.1%，三个民族间差异无统计学意义（P>0.05）。男性总体采取戒烟降糖的比率高于女性（χ2=16.711，P<0.001），白族内部性别差异有统计学意义（χ2=14.447，P=0.014），傣族和哈尼族内部性别差异无统计学意义（P>0.05）。见表3。
2.3.5　血糖控制率
调查对象整体的血糖控制率为47.7%，傣族、哈尼族和白族老年患者的血糖控制率分别为50.9%、58.8%和44.2%，三个民族间的血糖控制率无统计学差异（P>0.05）。按性别分层，民族间及性别间差异均不显著（P>0.05）。见表3。
3　讨论
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本次调查结果显示，云南农村中白族农村居民的患病率最高（15.9%），傣族次之，哈尼族最低。虽然白族老年人的患病率低于全国水平（19.4%）[10]，但高于以往云南地区的调查结果[11-12]。糖尿病往往由多种复杂因素共同作用，各地区或民族间糖尿病的患病差异可能与当地居民的饮食习惯、经济发展水平以及地域文化等因素密切相关[13]。本研究中白族居民生活水平相较之下较好，且既往调查显示白族居民典型的饮食及文化（如偏好腌制品或高盐饮食以及喜好烟酒等）可能是导致其糖尿病患病率较高的主要原因之一[14]。相比之下，哈尼族居民生活在较为偏远的高山地区，生活水平相对较低，因此患病率可能较低，提示应提升对白族农村地区糖尿病的健康教育和公共卫生干预力度。既往研究显示糖尿病患病率在80岁及以上高龄人群中可能趋于平稳或略有下降[15-16]。虽本研究未观察到糖尿病患病率随年龄增长的线性趋势，但65～79岁年龄组糖尿病患病率最高，提示该年龄段居民应作为糖尿病防控的重点人群。此外，三个少数民族内不同性别间糖尿病患病率差异均无统计学意义，这与其他地区的调查结果一致[17-18]。
在糖尿病自我管理方面，傣族、哈尼族、白族三个少数民族老年人按医嘱服药水平均较高。这一结果可能与基层临床医生在诊疗过程中给予的详细服药建议以及农村患者多数没有医学背景密切有关，多数患者认为药物治疗是控制血糖的最有效方法，因而依从性较好[6]。然而，与既往同类流行病学调查结果相似[19]，本研究中三个少数民族老年患者在血糖的自我监测方面表现均相对较差。在基层农村地区，对血糖监测的重要性认识不足，且医疗资源匮乏，导致血糖监测设备普及率较低或负担不起，即使一部分人能够负担，使用也会受到糖尿病教育不足和其他因素的影响[7,20]。提示在糖尿病管理中，应进一步加强患者对自我监测血糖重要性的认识，建议相关医疗机构通过加强对糖尿病患者的定期随访，提供必要的支持与培训，帮助患者建立起良好的血糖监测习惯。
与既往同类研究一致[12,18,21]，本研究显示三个民族老年糖尿病患者在过去两周内采取降糖措施的比率较高（98.4%）。在所调查的四类降糖行为中，采取率由高到低依次为饮食控制、增加锻炼、控制体重或减肥、戒烟。控制饮食是三个民族最常见的自我管理措施，其中白族患者控制饮食降糖的比率最高，为90.3%，哈尼族最低，为67.6%。中、低收入国家糖尿病患者的饮食依从性为29.9%～91.7%不等[21]，饮食调整无需依赖额外的设备或医疗资源，且对血糖控制有显著效果，因而许多患者对饮食建议的接受度较高。相比之下，三个少数民族患者采取减肥和额外锻炼来控制血糖的比率则较低，可能与调查对象为农村老年人有关，其面对着较为繁重的农活和体力劳动，采取减肥和额外锻炼的可能性较小。在戒烟方面，采取该措施的主要为男性，整体比例偏低。相关研究表明[22]，尽管农村地区的大多数吸烟者都知道吸烟有害健康，但现阶段吸烟者的受教育水平较低，会限制其充分认识吸烟对健康的危害程度及戒烟的益处，从而干扰了戒烟意愿。
此外，三个民族在接受治疗的老年糖尿病患者中血糖控制率为47.7%，略低于全国总体平均水平（50.1%）[3]，仍有超过一半的患者血糖并未达标。傣族、哈尼族和白族间血糖控制率差异无统计学意义，但整体达标率偏低，提示现阶段在上述群体中血糖控制效果仍有较大提升空间。
综上所述，傣族、哈尼族和白族三个民族间老年人的糖尿病患病水平和自我管理水平存在一定差异，自我管理能力仍需进一步提高，建议有关部门因地制宜，根据不同民族背景和健康需求，制定更具针对性的健康干预措施和管理方案，以提升少数民族地区老年人群的健康水平和糖尿病自我管理能力。
基金
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  • 国家自然科学基金(72064026)
  • 云南省科技厅-昆明医科大学联合专项重点项目(202401AY070001-027)
文献
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参考文献 引证文献
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2025年第52卷第17期
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doi: 10.20043/j.cnki.MPM.202410415
  • 接收时间：2024-10-25
  • 首发时间：2026-03-18
  • 出版时间：2025-09-10
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  • 收稿日期：2024-10-25
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国家自然科学基金(72064026)
云南省科技厅-昆明医科大学联合专项重点项目(202401AY070001-027)
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    昆明医科大学公共卫生学院，云南 昆明 650500

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
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