互联网+移动医疗模式下服用恩格列净2型糖尿病患者管理

Management of type 2 diabetes patients taking Empagliflozinin:a mode of internet+mobile medicine

目的探讨在互联网移动医疗管理下应用钠-葡萄糖协同转运蛋白2抑制剂(SGLT-2i)恩格列净治疗2型糖尿病的疗效。方法选择中国人民解放军总医院第一医学中心内分泌科2017年1月至2019年12月门诊收治的2型糖尿病患者97例,在原降糖方案基础上加用恩格列净。随机分为照护组及对照组,照护组49例采用互联网移动医疗管理,对照组48例采用门诊常规糖尿病管理。干预6个月后,分别比较2组临床相关指标、自我管理能力(包括饮食控制、遵医用药、监测血糖及戒烟合格率)及焦虑自评量表(SAS)评分。采用SPSS 16.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ^(2)检验。结果经过管理后,照护组及对照组体质量指数[(24.2±2.7)和(25.7±2.5)kg/m^(2)]、血糖[空腹血糖:(6.2±0.3)和(7.9±0.4)mmol/L;餐后2 h血糖:(9.5±0.5)和(10.7±0.7)mmol/L;糖化血红蛋白:(7.0±0.3)和(7.9±0.7)%]、甘油三酯[(1.41±0.57)和(2.09±0.62)mmol/L]、尿白蛋白/肌酐[(14.4±8.4)和(19.3±10.5)mg/mmol]比较,差异均有统计学意义(均P<0.05)。照护组患者饮食控制、遵医用药、监测血糖及戒烟合格率均高于对照组[38(77.6%)和12(25%),47(95.9%)和36(75%),44(89.8%)和31(64.6%),39(79.6%)和29(60.4%)],差异均有统计学意义(均P<0.05)。2组SAS评分比较,差异有统计学意义(P<0.05)。结论互联网移动医疗有可能改善口服恩格列净的2型糖尿病患者的临床指标,降低SAS评分,提高患者自我管理能力,比较适合于慢性病的长期管理。

Objective To investigate the efficacy of sodium-dependent glucose transporters 2 inhibitor(SGLT-2i)Empagliflozin in the treatment of type 2 diabetes mellitus(T2DM)in a management mode of the internet plus mobile medicine.Methods From January 2017 to December 2019,a total of 97 T2DM patients with poorly controlled blood glucose in the Outpatient of Endocrinology Department of Chinese PLA General Hospital were randomly divided into the care group(n=49)and the control group(n=48).The patients were treated with Empagliflozin in addition to the basic hypoglycemic regimen.The care group were managed in a mode of the internet plus mobile medicine,and the control group in the routine outpatient clinics.After 6 months,the two groups were compared in the clinical indexes,self-management abilities featuring diet control,medication compliance,blood glucose monitoring and smoking cessation qualified rate,and the scores of self-rating anxiety scale(SAS).SPSS statistics 16.0 was used for statistical analysis.Data comparison between two groups was performed using t test orχ^(2) test depending on data type.Results After management,the care group and control group differed in fasting blood glucose[(6.2±0.3)vs(7.9±0.4)mmol/L],2 h postprandial blood glucose[(9.5±0.5)vs(10.7±0.7)mmol/L],hemoglobin A1c[(7.0±0.3)vs(7.9±0.7)%],triglyceride[(1.41±0.57)vs(2.09±0.62)mmol/L],urine albumin to creatinine ratio[(14.4±8.4)vs(19.3±10.5)mg/mmol],and body mass index[(24.2±2.7)vs(25.7±2.5)kg/m^(2)](P<0.05 for all).The care group had higher qualified rates of diet control[38(77.6%)vs 12(25%)],medication compliance[47(95.9%)vs 36(75%)],blood glucose monitoring[44(89.8%)vs 31(64.6%)],and smoking cessation[39(79.6%)vs 29(60.4%)]than the control group,and the differences were statistically significant(P<0.05).The SAS scores between two groups was statistically significant(P<0.05).Conclusion The mode of internet plus mobile medicine can improve the clinical indicators of T2DM patients who take orally Empagliflozin,reduce anxiety scores,and enhance the patient′s self-management.It is suitable for long-term management of chronic diseases.