社区卫生服务中心2型糖尿病管理现况调查

Investigation on the management of type 2 diabetes in Community Health Service Center

目的对906例2型糖尿病患者社区管理现况进行分析,探讨其社区防治对策。方法收集906例2型糖尿病患者的血糖、血压、体重指数(BMI)、血脂和糖化血红蛋白(Hb A1c)等指标,并对其进行分析。结果1)建立档案的906例2型糖尿病患者中,控制较好的指标包括空腹血糖(FPG)、血压、主动有氧活动,达标率分别为70.97%、83.88%、73.62%,控制较差的指标有BMI、腰围,控制不良率分别为41.94%、61.15%。2)以FPG控制水平(FPG<7.0 mmol·L^(-1),FPG≥7.0 mmol·L^(-1))作为标准,将2型糖尿病分为血糖控制达标组和血糖控制未达标组,分析发现两组患者的血压、餐后2h血糖(2h PG)、高密度脂蛋白、甘油三酯、ALT差异有统计学意义(P<0.05)。3)50岁以下人群FPG控制欠佳,FPG随着BMI的增加而升高。结论社区2型糖尿病管理不仅要在饮食、运动、治疗方面对患者进行干预,且要重视对患者自我管理监测及宣教等多方面的干预,目前社区糖尿病患者存在超重、肥胖率高及患病年轻化等趋势。

Objective The community management in 906 patients with type 2 diabetes mellitus was analyzed to explore the prevention and treatment. Methods Blood glucose,blood pressure,BMI,blood lipid and HbA1c of 906 patients with type 2 diabetes mellitus were collected. Results 1） Of the 906 patients,the indicators including fasting blood glucose,blood pressure,and active aerobic activity were controlled better. Compliance rate was 70. 97%,83. 88%,and 73.62% respectively. The indicators including body mass index,and waist circumference were controlled poor. The defect rate was 41. 94% and 61. 15%. 2） The controlled level of FPG（ 7. 0 mmol·L^-1,≥7 mmol·L^-1） was as the dependent variables. Analysis and comparison found that two groups of blood pressure,two hour postprandial blood glucose,high density lipoprotein,triglyceride,and ALT were different significantly（ P〈0. 05）. 3） The control of fasting blood glucose in people under 50 years of age is not ideal. With the increase of body mass index,fasting blood glucose also increased.Conclusion The management of community type 2 diabetes should interfere not only in the diet,activity,treatment intervention for patients,and attaches great importance to the self-management of patient monitoring and other aspects of the education intervention. In view of the current community diabetes patients it appears overweight,obese and younger.It is necessary to explore the feasibility of mobile medical APP in the community to become a public service medical management platform.