당뇨병 ‘당화혈색소 검사’ 시행 빈도 낮고 지역별 차이 커

삼성서울병원 “당뇨병 관리 필수 ‘당화혈색소 검사’, 시행 빈도 낮고 지역별 차이 커”

삼성서울병원-서울대병원 연구팀, 당뇨병환자 4만여명 조사
1년 4번 검사 권고해도 100명 중 6명만 검사 받아
연구팀 “인식 전환 및 제도적 지원 뒤따라야”

▲사진=당뇨병 관리 필수인 당화혈색소 검사 시행 빈도가 낮고 지역별 차이도 큰 것으로 나타났다 ⓒ 강남구소비자저널

 

[강남구소비자저널=김은정기자]  당뇨병 조절 상태를 확인하기 위한 필수검사인 당화혈색소 검사의 시행 빈도가 여전히 낮고 지역별로도 크게 차이 나는 것으로 나타났다.

삼성서울병원 가정의학과 신동욱 교수, 서울대병원 가정의학과 조비룡 교수·유경훈 전공의 연구팀은 국민건강보험공단 자료를 이용하여 2013년 현재 당뇨병약을 처방 받고 있는 환자 4만3,283명의 당화혈색소 검사 빈도를 조사했다.

그 결과 국내 당화혈색소 검사의 시행률은 선진국에 크게 미치지 못할뿐더러 지역별로도 천차만별인 걸로 나타났다.

당화혈색소란 혈액 속 적혈구 내 산소운반에 중요한 단백질인 혈색소에 포도당 일부가 결합한 상태를 말한다.

일반적인 혈당검사가 검사 시점 혈당만을 알 수 있는 데 반해 당화혈색소를 검사하면 3개월간의 평균 혈당을 알 수 있다. 당뇨병으로 인한 합병증을 막기 위해 환자들의 혈당이 잘 조절되고 있는지 확인하기 위한 필수검사로 꼽힌다.

연구팀에 따르면 국내에서 1년 동안 1회 이상 당화혈색소 검사를 시행한 비율은 전체 환자의 67.3%에 불과했다. 선진국들의 경우 60~90% 사이인 것으로 알려져 있다.

이러한 비율은 검사 횟수가 늘수록 감소했다. 1년에 2회 이상 검사한 환자 비율은 37.8%로 급감했고, 4회 이상 검사한 경우는 6.1%에 그쳤다.

국내 권고사항을 보면 1년에 4번 당화혈색소 검사를 받도록 하고 있어 당뇨병환자 100명 중 6명만이 이를 지키고 있다는 의미다.

뿐만 아니라 연구팀이 국내 17개 시도, 251개 시군구 지역을 나눠 따로 분석한 결과 농촌 인구가 많이 포함된 지방의 검사 시행률이 상대적으로 더 낮았다.

특히 도서 지역이 많고 농촌 가구가 많은 전라북도와 전라남도의 경우 연간 1회 이상 검사를 받은 사람의 비율이 각각 59.6%, 60.6%로 전체 17개 시도 중 가장 낮았다.

이처럼 국내에서 당화혈색소 검사 시행 비율이 여전이 저조하고 지역별로 큰 차이를 보이는 데 대해 연구팀은 의료인과 환자들의 인식 부족을 주요 원인으로 꼽았다.

또 농어촌 지역에서 당뇨병 환자를 관리하는 1차 의료기관의 경우 이들 환자를 검사할 인력이나 검체를 분석할 시설과 기회가 모자라는 경우가 많은 점도 원인 중 하나로 지목됐다.

이번 연구 교신저자인 신동욱 교수는 “당뇨병의 적절한 관리를 위해서는 당화혈색소를 적극적으로 검사해야 하지만 상대적으로 손쉽게 측정할 수 있는 혈당만을 모니터링하고 있는 경우가 많다”며 “제대로 당뇨병을 관리하기 위해서는 정기적인 당화혈색소 검사와 연 1회 미세단백뇨, 안저검사 등 합병증 검사가 필수다”고 강조했다.

연구과제 책임자인 조비룡 교수는 “1차 의료기관이 만성질환의 관리를 위한 시설과 인력 갖추고, 저소득층의 경우에는 필수검사 비용에 대한 부담을 느끼지 않도록 하는 등 제도 설계와 지원이 필요하다”고 말했다.

한편 이번 연구는 한국 보건의료연구원의 연구지원으로 이루어졌으며, 국제학술지인 ‘당뇨병 연구 및 임상의학회지(Diabetes Research and Clinical Practice)’ 최신호에 발표됐다.

 

 

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