社区随访新模式对2型糖尿病患者血糖和代谢指标的影响

Effects of community follow-up new models on blood glucose and metabolic indicators in patients with type 2 diabetes mellitus

目的观察社区随访新模式对2型糖尿病(T2DM)患者血糖和代谢指标的影响。方法T2DM患者240例随机均分成传统社区随访(A)组、联合随访(B)组及中心随访(C)组。随访3、6个月后,评估三组血糖、血压、血脂及低血糖事件发生情况。结果本研究共228例完成随访,失访11例,退出研究1例。与出院时比较,随访3个月后,B、C组患者HbA1c、FBG、餐后2h血糖、TC、TG、LDL-C及BP降低(P<0.05),而A组无明显变化(P>0.05)。随访6个月后,A组患者HbA1c、餐后2h血糖、TC、TG及BP较出院时降低(P<0.05),而FBG和LDL-C无明显下降(P>0.05)。A、B、C组分别有10、5、2例发生低血糖事件,组间比较差异有统计学意义(P<0.05)。结论内分泌专科医生指导下的社区随访新模式可以更有效地控制T2DM患者的血糖、血压和血脂,减少低血糖事件的发生。

Objective To observe the effects of community follow-up new models guided by endocrinologist on the blood glucose and metabolic indicators in the patients with type 2diabetes mellitus（T2DM）.Methods A total of 240 patients with T2 DM was equally randomized into three groups of A（received conventional community follow-up）,B（received combined follow-up）and C（received central follow-up）.The relevant indicators were evaluated in 3and 6months during follow up.Results A total of 228 cases was followed up,11 cases were lost,1case was withdrawn.Compared to before,the levels of HbA1 c,FBG,2hBG after meal,TC,TG,LDL-C and BP in groups of B and C after 3 months of follow-up were significantly decreased（P〈0.05）,which were not remarkably changed in group A（P〉0.05）.After 6months of follow-up,the levels of HbA1 c,2hBG after meal,TC,TG and BP in group A were decreased significantly（P〈0.05）,while FBG and LDL-C were not significantly decreased（P〉0.05）.The hypoglycemia occurred in 10,5,and 2cases in groups of A,B,and C,respectively（P〈0.05）.Conclusion The community following-up under the guidance of endocrinologist can more efficiently manage the glucose,BP and blood fat,and reduce the occurrence of hypoglycemia events in T2 DM patients.