社区分级管理对初诊2型糖尿病患者代谢和并发症的影响

Effect of Community Grade Management on Metabolic Changes and Diabetic Complications in Patients with Newly Diagnosed Type 2 Diabetes

目的:探讨社区分级管理对初诊2型糖尿病患者代谢和并发症的影响。方法:选择社区264例糖尿病患者随机分为干预组和对照组。实验前对两组患者血糖水平分别进行评估,并根据血糖控制水平分为血糖控制满意和血糖控制不满意两组。干预组患者按照血糖控制水平分别纳入不同的管理级别,对照组统一采用常规糖尿病健康教育。结果:干预、随访4年后,干预组血糖代谢达标率均好于对照组(P<0.01),糖尿病并发症发生率显著低于对照组(P<0.05);且血糖控制不满意者的下降率较对照组明显,差异有统计学意义(P<0.01)。结论:对社区初诊2型糖尿病患者实施全方位的社区分级管理,可改善患者的各项代谢指标及血糖水平,同时有利于降低患者并发症。

Objective To evaluate the effect of community grade management on metabolic changes and diabetic complica- tions in patients who are newly diagnosed with type 2 diabetes. Methods Two hundred and sixty-four community-dwelling patients with newly diagnosed type 2 diabetes were randomly divided into two groups. Based on the assessment of the levels of blood glucose of newly diagnosed type 2 diabetics, the patients in both groups were classified the normal blood glucose group and abnormal blood glucose group. The patients in the experimental group received grade management based on the control levels of blood glucose,while the patients in the control group following routine diabetic health education. Results After interventions that persisted to 4 years follow up, the compliance rates of glucose metabolism were significantly improved in the experimental group than those of the control group（P 〈0.01 ） ,and the incidence rates of diabetic complications were also significantly reduced following grade management. Moreover, the satisfaction degrees of blood glucose control of patients were significantly higher in experimental group than the control group （ P 〈 0.01 ）. Conclusion Community grade manage- ment based on the levels of blood glucose can improve the control of metabolic index and blood glucose in patients with new- ly diagnosed diabetes, especially diabetic complications.