远程医疗模式在2型糖尿病综合管理中的应用

The application of telemedicine in the integrated management of type 2 diabetes mellitus

目的为探索基于网络的糖尿病综合管理模式,建立"U-健康管理(U-Healthcare)"糖尿病远程医疗服务平台,验证其有效性及实用性。方法从我科门诊就诊的T2DM患者中筛选220例,并分为两组。试验组用具数据传输功能的血糖仪传送血糖数据,获得医疗组药物、饮食、运动等糖尿病UHealthcare综合管理,对照组维持传统就诊模式。两组在3个月和6个月时随访。结果 3个月时,试验组FPG较基线[(8.3±2.9)vs(7.1±1.7)mmol/L,P=0.001]和对照组[(7.9±2.4)vs(7.1±1.7)mmol/L,P=0.038]降低。试验组TG较基线降低[(2.9±2.4)vs(2.0±1.9)mmol/L,P=0.000]。6个月时,试验组2 hPG较基线和对照组降低,HbA_1c每3个月呈阶段性降低(P<0.05)。结论基于网络的糖尿病U-Healthcare综合管理不仅能有效控制血糖、降低HbA_1c、改善血脂,也能提高患者依从性。

Objective To explore the mode of the internet-based integrated management of diabetes,we established a platform（U-Healthcare） of diabetes remote medical service and assess the effectiveness and practicality of it.Methods A total of 220 patients with type 2 diabetes were recruited from outpatient clinic in our department and randomly divided into two groups.In the experimental group,glucometers with data transmission function were used to send blood sugar data,and got medicine,diet,exercise and other management of U-healthcare system.In control group,all the subjects maintained conventional medical intervention.All patients were regularly followed up every three months for half a year.Results At the end of 3 months＇ follow up,fasting blood glucose（FPG）were significantly lower in the experimental group than the baseline[（8.3 ＋ 2.9） vs（7.1 ± 1.7）mmol/L,P = 0.001],and control group[（7.9±2.4） vs（7.1±1.7）mmol/L,P=0.038].And triglyceride was also decreased than baseline in experimental group[（2.0＋1.9） vs（2.9 ± 2.4）mmol/L,P=0.000].At the end of 6 months＇ followup,2 h postprandial blood glucose（2 hPG） in the experimental group was also improved significantly than baseline and control group.The HbA1c of the experimental group dereased gradually every there months,and the mean change of it was greater than control group（P〈0.05）.Conclusion The internet-based U-healthcare system of the integrated management in diabetes could achieve better glycemic control,effectively improve HbA1c decrease TG,and enhance patients＇ adherence to medical team.