远程血糖管理系统在社区2型糖尿病管理中的应用效果研究

Application of the Remote Blood Glucose Control System for Type 2 Diabetes Mellitus Management in Community

目的探讨远程血糖管理系统在社区2型糖尿病管理中的应用效果。方法选取2012年6月—2013年5月在北京市西城区什刹海社区卫生服务中心内已诊断且血糖控制不佳的2型糖尿病患者363例,采用整群随机法分为对照组(n=184)和试验组(n=179)。对照组患者采用常规血糖管理,试验组患者采用远程血糖管理,两组患者均随访1年。比较两组患者干预前及干预后3、6、12个月的空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、收缩压(SBP)、舒张压(DBP)及7 d健康饮食量。结果两组患者FPG、TC、HDL-C、LDL-C、Cr、7 d健康饮食量比较,差异有统计学意义(P<0.05);不同时间点比较,差异有统计学意义(P<0.05);干预方法和时间在FPG、TC、HDL-C、LDL-C、Cr、7 d健康饮食量上存在交互作用(P<0.05)。两组患者Hb A1c、TG、SBP比较,差异无统计学意义(P>0.05);不同时间点比较,差异有统计学意义(P<0.05);干预方法和时间在Hb A1c、TG、SBP上存在交互作用(P<0.05)。两组患者DBP比较,差异无统计学意义(P>0.05);不同时间点比较,差异无统计学意义(P>0.05);干预方法和时间在DBP上无交互作用(P>0.05)。结论远程血糖管理系统在社区2型糖尿病管理中的应用效果较好。

Objective To explore the application of the remote blood glucose control system for type 2 diabetes mellitus(T2DM)management in community.Methods A total of 363 newly diagnosed but poorly controlled T2DM patients from Shichahai Community Health Service Center were selected in Xicheng District of Beijing from June 2012 to May 2013.They were randomly divided into the control group(n=184)and the experimental group(n=179)by random number table.Patients in the control group received conventional blood glucose management while the community health service center carried out remote blood glucose control on patients in the experimental group.Patients in both groups were followed up for one year.Results of laboratory examinations before the intervention and 3,6 and 12 months after the intervention were compared between two groups,which included fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),creatinine(Cr),systolic blood pressure(SBP),diastolic blood pressure(DBP)and a seven-day diet control.Results Test results of FPG,TC,HDL-C,LDL-C,Cr and the seven-day diet control differed significantly in two groups(P<0.05).These results differed significantly between two groups at different time points(P<0.05).Intervention methods and different time points had an interaction on the results of FPG,TC,HDL-C,LDL-C,Cr and the seven-day diet control(P<0.05).There were no significant differences in HbA1c,TG and SBP between two groups(P>0.05),but they showed significant differences in the same group at different time points(P<0.05).Intervention methods and different time points had an interaction on the results of HbA1c,TG,and SBP(P<0.05).The DBP results showed no significant differences between two groups(P>0.05)or at different time points(P>0.05).There was no interaction on DBP between intervention methods and different time points(P>0.05).Conclusion Remote blood glucose control system has positive effects on type 2 diabetes mellitus management in community and improves patients'metabolism.