家庭医生干预对社区糖尿病高危人群的影响

Influence of family doctor intervention on the community high risk population of diabetes

目的:观察对糖尿病前期患者进行家庭医生强化生活方式干预的效果。方法:2013年至2015年,每年的2月至6月,按照中国2型糖尿病(T2DM)防治指南标准,对杨浦区长白街道社区户籍居民中≥40岁的720名T2DM高危人群进行空腹血糖(FBG)及餐后2 h血糖(2h PG)筛查,对糖调节受损(IGR)患者进行家庭医生强化干预,实施深化健康管理。干预后,比较三年中IGR患者及T2DM患者检出率、IGR患者及T2DM患者中的FBG及2h PG的最高数值变化以及IGR患者的转归情况。结果:干预后IGR患者及T2DM患者检出率呈下降趋势(P<0.05);IGR患者及T2DM患者FBG及2h PG最高数值呈下降趋势(P<0.05);IGR患者转为正常的比率升高,转为T2DM患者的比率下降(P<0.05)。结论:家庭医生强化生活方式干预有助于降低前期人群向糖尿病转化的概率,从而达到预防和控制糖尿病发病率。

Objective： To observe the effect of the family doctor to strengthen life style intervention on the patients in the early stage of diabetes. Methods： From February to June of 2013 to 2015, according to the standards of Chinese type 2 diabetes mellitus（T2DM） prevention and treatment guidelines, fasting blood glucose（FBG） and postprandial 2 h blood glucose（2hPG） of 720 community permanent residents over 40 years with type 2 diabetes（T2DM） in high risk were screened in Changbai Neighborhood Community of Yangpu District. Family doctor intensive intervention was given to the patients with impaired glucose regulation0GR）, and the deepening of health management was implemented for them. After intervention, detection rates of IGR and T2DM patients, the changes of the highest values of FBG and 2hPG in patients with IGR and T2DM and the prognosis of patients with IGR were compared for the three years. Results： After the intervention, the detection rates of IGR and T2DM patients showed a downward trend（P〈0.05）. The highest values of FBG and 2hPG decreased in IGR and T2DM patients（P〈0.05）. The rate of IGR patients turned to normal increased, and rate of conversion to T2DM patients decreased（P〈0.05）. Conclusion： Family doctor strengthening lifestyle intervention is helpful to reduce the probability of conversion of the pre-diabetic population to diabetes so as to prevent and control its incidence.