互联网+糖尿病共同照护模式的线上自我管理支持对规律复诊2型糖尿病患者代谢指标影响的研究

Influence of remote diabetes self-management support in the background of internet plus diabetes shared care model on metabolic profiles in regularly follow-up patients with type 2 diabetes mellitus

目的观察互联网+DM共同照护模式的线上自我管理支持对接受规律管理的T2DM患者代谢指标的影响。方法选取2016年10月至2018年12月于北京大学第一医院内分泌科糖尿病共同照护门诊规律随诊超过半年的T2DM患者516例,分为达标组(n=229)及不达标组(n=287),比较两组基本信息、历次就诊时HbA_(1)c、降糖药物使用等资料,Logistic回归分析HbA_(1)c达标的影响因素。结果两组基线资料比较,差异无统计学意义(P>0.05)。Logistic回归分析显示,DM病程<5年(OR 1.612,95%CI 1.040,2.497)、不使用Ins(OR 3.825,95%CI 2.567,5.698)、基线HbA_(1)c达标(OR 7.391,95%CI 4.858,11.245)及高强度线上支持水平(OR 1.705,95%CI 1.162,2.501)是规律随访后1年HbA_(1)c达标的影响因素。结论在互联网+DM共同照护门诊管理模式下,执行线上自我管理支持>33.84 min/季度,可提高患者规律随访后1年HbA_(1)c达标率。

Objective To investigate the influence of remote diabetes self-management support on metabolic profiles in regularly follow-up patients with type 2 diabetes mellitus(T2DM)in Internet plus Diabetes Shared Care model.Methods A total of 516 patients with T2DM who were regularly followed up in Internet plus Diabetes Shared Care model more than half a year were enrolled in this study from October2016 to December 2018.All the patients were divided into achieving target group(n=229)and Not achieving target group(n=287).Demographic data,HbA_(1)c in each visit and diabetic medications were compared between the two groups.Logistic regression analysis was used to explore the influencing factors for target HbA_(1)c achievement.Results There was no significant difference in baseline data between the two groups(P>0.05).Logistic regression analysis showed that disease duration<5 years(OR 1.612,95%CI1.040,2.497),no insulin usage(OR 3.825,95%CI 2.567,5.698),target HbA_(1)c achievement at baseline(OR 7.391,95%CI 4.858,11.245)and high-intensity of online support(OR 1.705,95%CI1.162,2.501)were the influencing factors for target HbA_(1)c achievement after regular follow-up for 1 year.Conclusion In Internet plus Diabetes Shared Care model,remote diabetes self-management support(>33.84 min/quarter)could improve 1-year HbA_(1)c achievement in patients with regular follow-up.