个体化随访体检模式对≥75岁2型糖尿病患者血糖及体质量状况影响的随机对照研究

Effects of health check-up feedback style （HCFS） on blood glucose and weight in type 2 diabetes patients aged 75 years and older： a randomized controlled study

目的 探讨体检后采用个体化随访模式（HCFS）对≥75岁2型糖尿病患者血糖控制水平及体质量状况的影响.方法 定点连续选取规律于北京协和医院年度体检、采用纸质体检报告行体检反馈,年龄≥75岁的2型糖尿病患者共120例.随机将患者分为对照组和研究组.全部患者2014年11月至2015年10月行年度体检（基线体检）,继续原方案对对照组反馈,研究组则以个体化随访方式进行体检反馈.2015年11月至2016年10月全部患者再次（第2次）年度体检,对比患者体检时血糖水平及体质质量状况.结果 基线体检时两组糖化血红蛋白（HbA1c）水平和体质指数（BMI）无差异,第2次体检时研究组HbA1c水平和BMI低于对照组[（7.17±0.58）％比（7.44±0.72）％,P=0.027;（24.3±3.8）kg/m2比（25.0±4.2） kg/m2,P=0.049];两组空腹血糖和腰围无差异.结论 体检后进行个体化随访,采用联合纸质体检报告和当面或电话提醒的方式进行体检反馈,更有利于≥75岁2型糖尿病患者血糖的长期稳定和理想体质量的维持.健康体检后体检反馈方式的选择非常重要.

Objective To analyze the effect of health check-up feedback style （HCFS） on the blood glucose level and weight of type 2 diabetes patients aged 75 years and older.Methods 120 consecutive patients with type 2 diabetes and aged 75 and older who were taking annual health check-up and receiving paper-based medical examination reports at Peking Union Medical College Hospital were enrolled into this study.The patients were randomly divided into two groups （control group and study group）.All patients received annual health check-up between November 2014 and October 2015 （baseline health check-up）.Patients in control group were given paperbased feedback as usual,while those in study group received feedback via face-to-face or telephone conversations.All patients received their second annual health check-up between November 2015 and October 2016.The patients＇ blood glucose and weight at the second health check-up were compared between the two groups.Results In baseline health check-up,the levels of HbA1c and BMI showed no difference between the two groups.In the second health check-up,HbA1c and BMI of study group were lower than control group [（7.17±0.58）％ vs.（7.44±0.72）％,P=0.027;（24.3±3.8） kg/m2 vs.（25.0±4.2） kg/m2,P=0.049].Fast blood glucose and waist circumference showed no difference between the two groups.Conclusions Combination of paper-based reports and face-to-face or telephone conversations to feedback on health check-up results led to better blood glucose and BMI control in old aged type 2 diabetes patients.HCFS is of vital importance.