糖尿病强化管理对改善患者代谢紊乱状态的作用及意义

Significance of strengthened management on metabolic control in outpatients with type 2 diabetes

目的了解糖尿病综合性强化管理对改善患者各项代谢指标控制状况的影响。方法比较我科电子病历库中1 367例坚持随访患者与281例失访患者首次就诊时以及当前状态下的血糖、血脂、糖化血红蛋白 (HbA1 c)及体重指数(BMI)等资料,了解两组患者各项指标的控制情况。结果随访组患者HbA1 c和血压的控制达标率明显好于失访组(P<0．05),随访组患者空腹血糖、餐后2 h血糖、HbA1 c、血脂及BMI的下降幅度均显著大于失访组(P<0．05),两组血脂的差异无显著性(P>0．05)。结论个体化、综合的糖尿病管理模式的实施可以明显改善患者各项代谢指标的控制情况。

Objective To evaluate the efficacy of the comprehensive strengthened management on metabolic control in outpatients with type 2 diabetes. Methods We selected 1 367 patients with type 2 diabetes who were followed-up for 3 years and 281 patients with same of type diabetes who were lost or follow up again of their metabolic control from their original and recent data, including plasma glucose, blood lipid, HbAlc and body mass index （BMI）. The outcoming efficacice of anti-diabetic therapy of the two groups were compared. Results The control rates of HbAlc and blood pressure in the follow-up group were better than those lost of follow-up group （P〈0.05）, but the control rates of blood lipid were of no significant difference between the two groups. Improvementg in fasting and postprandial blood glucose, HbAlc, blood lipid and BMI were obviously better in the follow-up group than those of the lost follow-up group （P〈 0.05）. Conclusions Individualization and comprehensive management of diabetes can remarkably improve diabetic patients＇ metabolic control. （Shanghai Med J, 2006, 29： 214-216）