2型糖尿病“三一模式”管理现状及分析

Analysis of the status and risk factors of “3-1 mode” management of type 2 diabetes

目的评价乌鲁木齐市新市区实施"三一模式"(医院-社区-体化)管理2型糖尿病患者(T2DM)的效果。方法对乌鲁木齐市新市区2017年3-9月已经成功建档并参与"三一模式"管理的7 872名2型糖尿病患者,随访6个月,知晓其管理的现状,并对建档时、3个月、6个月随访结果的血糖、血脂和血压指标进行分析。结果 7 872例研究对象中随访失访321人,T2DM研究人群中合并高血压的有3 067名,占总人群的40.62%。自建档至3个月以及6个月的随访结果显示,FBG与2 h PBG差异有统计学意义(P<0.01),血糖管理降糖有效;SBP、TG、HDL-C水平差异有统计学意义(P<0.05),DBP、TC、LDL-C水平差异无统计学意义(P>0.05),收缩压管理有效,血脂管理效果不明显。一周运动>4次,每次运动时间>30min,以及不吸烟为随访结果满意的保护因素,主食摄入量>200g为危险因素。结论医院-社区一体化管理2型糖尿病在乌鲁木齐市新市区有效,可为后续实施该模式提供合理指导。

Objective To implement the model of Trinity（hospital-community integration）in the new urban area of Urumqi to manage type 2 diabetes patients and analyze the management results.Methods A total of 7 872 patients with type 2 diabetes who successfully documented and participated in the model management in the new urban area from March 2017 to September 2017 were followed up for 6 months.The current status of their management was known and the laboratory results were analyzed.Results A total of 7 872 subjects were enrolled and 321 were lost to follow-up at this follow-up.Among the study population complications,3 067 were associated with hypertension,accounting for 40.62% of the total population.Stage-by-phase comparison：Results of blood glucose,blood pressure,and blood lipid correlation showed that blood glucose management was effective（FBG and 2 hPBG,P〈0.01）,systolic blood pressure was different,management was effective（SBP,P〈0.05）,and lipid management was not effective（TG,HDL-C,P〈0.05）.The results of the risk factors analysis of the follow-up results showed that the exercise was performed more than 4 times a week and the exercise time was 〉30 minutes;and no smoking was a satisfactory protective factor for follow-up results.The intake of the staple food was〉200 g as a risk factor.Conclusion The hospital-community integrated management of type 2 diabetes is effective in the new urban area of Urumqi.It provides reasonable guidance for the follow-up implementation of the model.