지역사회 당뇨병 유병자에서 당뇨병 이환 기간에 따른 건강관리 지표의 차이: 2018년 지역사회건강조사 분석
Differences in the Level of Health Care Indicators According to the Duration of Diabetes among Community-Dwelling People with Diabetes Mellitus: Analysis of the 2018 Community Health Survey in Korea
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연구배경: 본 연구는 지역사회 당뇨병 유병자를 대상으로당뇨병 이환 기간에 따라 건강관리 지표들의 수준 차이가있는지를 확인하고자 하였다. 방법: 지역사회건강조사 2018년 원자료에서 40-79세의 당뇨병 유병자 20,113명을 분석 대상으로 하였다. 당뇨병 이환기간에 따른 당뇨병 유병자의 분포는 4년 이하 34.9%, 5-9년22.4%, 10-14년 18.9%, 15-19년 9.4%, 20년 이상 14.1%였다. 결과변수인 건강관리 수준은 8개의 건강행태 지표와 7개의 당뇨병관리 지표로 평가하였다. 결과: 인구사회학적 변수들을 보정한 후 이환 기간이 길수록 연간 음주는 감소하고, 인플루엔자 예방접종은 증가하는 경향을 보인 반면, 규칙적 칫솔질 실천, 주관적 스트레스수준, 우울감 경험은 불건강해지는 경향을 보였다. 현재 흡연, 규칙적 걷기 실천, 영양표시 활용은 당뇨병 이환 기간에따른 차이가 없었다. 당뇨병 이환 기간이 길수록 본인 인지혈당 조절은 부정적인 경향이었지만, 당뇨병관리 교육 및당화혈색소검사, 당뇨병성 안질환 합병증검사, 당뇨병성 신장질환 합병증검사는 유의하게 증가하는 경향을 보였다. 당뇨병의 주요 합병증인 심근경색증 및 뇌졸중 조기증상에 대한 인지는 당뇨병 이환 기간에 따른 차이가 없었다. 결론: 당뇨병이 오래 지속되는 유병자들은 합병증 발생위험이 높은 고위험군이므로, 이들을 대상으로 건강행태 개선을 위한 보다 적극적인 지역사회 전략이 필요하다.
Abstract
Background: This study aimed to determine whether the levels of healthcare indicators vary according to the duration of diabetes in diabetic people. Methods: From the 2018 Korean Community Health Survey, a total of 20,113 diabetic people aged 40-79 years were analyzed. The distribution of people with diabetes and its corresponding diabetes duration were as follows: 34.9%, less than 4 years; 22.4%, 5-9 years; 18.9%, 10-14 years; 9.4%, 15-19 years; and 14.1%, more than 20 years. Outcome variables included eight health behavior indicators and seven diabetes management indicators. Results: After adjusting for the sociodemographic characteristics, the longer the duration of diabetes, the less alcohol drinking and the more influenza vaccination was availed, whereas the regular tooth brushing, perceived usual stress, and perceived depressive symptoms tended to be unhealthy. Smoking, regular walking, and utilizing food nutrition label did not differ based on the duration of diabetes. Moreover, blood glucose control was evaluated to be poorly controlled as the duration of diabetes lengthened; however, diabetes management education and medical institution services (glycated hemoglobin measurement, diabetic retinopathy screening, and diabetic nephropathy screening) tended to increase significantly. There was also no difference in relation to diabetes duration in the recognition of early symptoms of myocardial infarction and stroke, which are the major complications of diabetes. Conclusions: People with long-lasting diabetes are at a higher risk of developing diabetes-related complications; therefore, more active community strategies are needed to improve their health behavior.
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