“血糖管理三人行”随访模式对超重/肥胖2型糖尿病患者血糖和体重控制的影响

The effects of glycemic and weight control under the model of “blood glucose management group” for type 2 diabetes who have overweight or obesity

目的:探讨"血糖管理三人行"模式随访12周后对超重/肥胖2型糖尿病(T2DM)患者血糖和体重的影响。方法:收集2018年1月至2019年8月在鄂东医疗集团黄石市中心医院内分泌科门诊及住院的超重/肥胖的2型糖尿病患者,接受基础胰岛素治疗共297例。其中147例自愿加入"血糖管理三人行"项目的患者为研究组,另150例自愿加入我科常规随访的患者为对照组,比较随访12周后两组血糖和人体质量指数(BMI)的变化情况。结果:经过12周的随访,研究组和对照组的空腹血糖(FBG)、餐后2 h血糖(2hPG)均有下降;实验组血糖降幅更大(P<0.01),且研究组随访后空腹血糖平均值达到控制标准;与基线BMI相比,研究组中超重人员和肥胖人员的BMI均下降且差异有统计学意义(P<0.01),但对照组中超重人员和肥胖人员BMI变化差异无统计学意义(P>0.05)。研究组超重/肥胖人员BMI降幅平均值与对照组比较有显著统计学差异(P<0.01)。结论:对于超重或肥胖的2型糖尿病患者,"血糖管理三人行"模式在减轻体重和改善血糖控制方面更有效。

Objective: To explore the glycemic control and weight effects of type 2 diabetes( T2 DM) with overweight or obesity after the 12 weeks follow-up under the model of "blood glucose management group ".Method: From January 2018 to August 2019,a total of 297 overweight or obesity T2 DM patients,who using basal insulin treatment in our hospital,agreed to participate in the study. Among them,147 patients joined the " blood glucose management group"were in the study group,and 150 patients joined the routine follow-up were in the control group. After the 12 weeks follow-up,a comparison was made between the two groups on the blood glucose and body mass index( BMI). Results: After 12 weeks follow-up, fasting blood glucose( FBG),2-hourpostprandial blood glucose( 2 h PG) were all significantly reduced compared to baseline in the two groups( P<0. 01). The mean decline range of blood glucose was significantly greater in the study group compared to the control group( P < 0. 01). FBG reached the control standard in the study group. In comparison with baseline,BMI of the study group was significantly decreased,while BMI of the control group had not changed( P > 0. 05). The mean BMI loss was significantly greater in the study group than the control group( P < 0. 01). Conclusions: The "blood glucose management group " is effective in reducing BMI and improvement of blood glucose control for T2 DM patients with overweight or obesity.