社区2型糖尿病诊治管理的临床研究

Study of Management of Type 2 Diabetes in Community

目的探讨糖尿病社区、医院、社区-医院一体化管理的效果,寻求最适合糖尿病患者诊治的管理方案。方法 210例2型糖尿病患者分为A组(社区治疗组)、B组(医院治疗组)、C组(社区-医院双向转诊组)3组。分别随访2年后比较三组的空腹血糖、餐后2h血糖、糖化血红蛋白、24h尿微量清蛋白、眼底、治疗费用及患者满意度。结果三组患者的空腹血糖、餐后2h血糖及糖化血红蛋白较2年前均有显著改善,B组及C组的餐后2h血糖及糖化血红蛋白的比A组低。A组的医疗费用最低。C组的患者满意度最高。结论社区、医院、社区-医院一体化管理均可改善糖尿病患者的血糖水平。社区-医院一体化管理更适合社区糖尿病的诊治。

Objective To study the effect of managements in community, hospital and community - hospital of type 2 diabetes mel- litus. Methods 210 type 2 diabetes mellitus were divided into group A （ followed in community）, group B （ followed in hospital）, group C （followed in community, transferred to hospital necessary）. Fasting plasma glucose, postprandial plasma glucose, HbA1 e, micro -al- bumen and retinapathy were measured before and after 2 years follow - up in three groups. Expenses and satisfaction were evaluated after 2 years follow -up in three groups. Results Fasting plasma glucose, postprandial plasma glucose and HbAI c of patients decreased sig- nificantly in three groups after 2 years follow - up. Postprandial plasma glucose and HbA1 c of patients of group B and group C were lower than those of group A. Expenses were lowest in group A, Satisfaction was highest in group C. Conclusion Management in community - hospital fits type 2 diabetes mellitus in community.