上海某社区糖尿病前期人群微信干预的效果及成本分析

Intervention Effects and Costs of the Pre-diabetes Population in a Community in Shanghai City with WeChat

背景糖尿病前期是发展为糖尿病的高危阶段,干预糖尿病前期患者的生活方式能减少糖尿病的发生风险,但通过微信管理糖尿病前期人群并对该管理方法的效果和成本做分析方面的研究却鲜有报道。目的探讨家庭医生团队通过微信干预糖尿病前期人群的效果及成本。方法2019年1-9月从上海市虹口区广中路街道社区卫生服务中心数据库中筛选出符合标准的糖尿病前期患者,采用随机数字表法分为非干预组、传统组、微信组,每组50例。非干预组仅在门诊就诊时进行口头健康教育,传统组用传统强化方式干预,微信组通过微信干预,干预期6个月。比较三组患者干预前后的空腹血糖(FBG)和餐后2 h血糖(2 hPG)水平。结果干预后,微信组与传统组的FBG、2 hPG均低于非干预组(P<0.05)。非干预组2 hPG干预后高于干预前,传统组与微信组干预后FBG、2 hPG均低于干预前(P<0.05)。传统组与微信组转为正常的比例均高于非干预组,传统组与微信组转为糖尿病的比例均低于非干预组(P<0.0167)。微信组的干预人均成本36.4元,传统组的干预人均成本104元,微信组的干预人均成本是传统组的35%。结论家庭医生利用微信干预糖尿病前期人群是一种经济、可行、有效的管理方法。

Background Prediabetes is a high-risk stage for diabetes development.Intervening in the lifestyle of people with prediabetes can reduce the risk of developing diabetes.However,there were few reports on WeChat management of pre-diabetes population and analysis of the effect and cost of this management method.Objective To explore the intervention effects and costs of the pre-diabetes population with WeChat by family physician team.Methods This study was conducted from January 2019 to September 2019.The standard pre-diabetes patients were selected from the database of Guangzhong Street Community Health Service Center of Hongkou District.The patients were divided into non-intervention group,traditional intervention group and WeChat group by random number table method,with 50 patients in each group.In the non-intervention group,health education was only provided in the outpatient department;in the traditional group,intervention was conducted in the traditional strengthening way;in the WeChat group,intervention was conducted in the WeChat way.The intervention period was 6 months.Fasting blood glucose(FBG)and 2 h postprandial blood glucose(2 hPG)levels before and after intervention were compared in the three groups.Results After the intervention,FBG and 2 hPG in WeChat group and traditional group were lower than those of non-intervention group,and 2 hPG in non-intervention group was higher than that before intervention(P<0.05).FBG and 2 hPG in traditional group and WeChat group after intervention were lower than those before intervention(P<0.05).The conversion rate to normal of the traditional group and WeChat group was higher than that of the non-intervention group,and the conversion rate to diabetes of the traditional group and WeChat group was lower than that of the non-intervention group(P<0.0167).The per capita intervention cost of the WeChat group was 36.4 yuan,which was 35%of that of the traditional group,compared with 104 yuan in the traditional group.Conclusion It is an economic,feasible and effective new management method for family doctors to intervene in the pre-diabetes population with WeChat.