综合性强化管理结合二甲双胍治疗在社区糖尿病患者中的应用

Application of comprehensive intensified management combined with metformin to diabetic patients in community

目的:探讨综合性强化管理结合二甲双胍在社区糖尿病患者中的应用效果。方法:选取社区健康服务中心收治的192例2型糖尿病患者,随机分为对照组和管理组,每组96例。两组均应用二甲双胍治疗,在此基础上,管理组采用综合性强化管理,对照组采取常规管理。干预随访3年后,比较两组患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb A1c)、体质指数(BMI)改善效果,同时观察比较两组患者随访期间并发症发生情况。结果:入组前两组患者一般资料比较差异无统计学意义(P>0.05);随访3年后,管理组FPG、2 h PG、Hb A1c及其达标率显著优于对照组,差异有统计学意义(P<0.05),同时管理组糖尿病并发症发生率较对照组低,差异有统计学意义(P<0.05)。结论:二甲双胍结合综合性强化管理对社区糖尿病患者血糖控制效果优于常规管理,能够减少糖尿病并发症的发生。

Objective： To investigate the application effect of comprehensive intensified management combined with metformin on patients with diabetes in the community. Methods： A total of 192 patients with type 2 diabetes admitted to our community health service center were randomized into the control group and management group with 96 cases in each group. Metformin treatment was giving to both groups. Besides,the management group adopted comprehensive intensified management,while the control group adopted routine management. Three years after the intervention and follow-up,the effect of fasting plasma glucose（FPG）,2 h postprandial blood glucose（2 h PG）,glycosylated hemoglobin（Hb A1 c）,and body mass index（BMI） of patients in both groups were compared. Complications occurred in patients between the two groups during follow-up were compared. Results： The baseline data of the two groups before study were identical,there was no significant difference（P 〈0. 05）; 3 years after follow-up,FPG,2 h PG,Hb A1 c and other indicators in the management group were significantly better than those of the control group,and the differences were statistically significant（P 〉0. 05）. At the same time,the incidence of diabetic complications in the management group was lower than that in the control group,which was of statistical difference（P〈0.05）. Conclusion： Metformin combined with comprehensive intensified management is superior to routine management over glycemic control in diabetic patients in the community and can reduce the occurrence of diabetic complications.