“互联网+”管理模式在妊娠期糖尿病患者中的应用

Application of "Internet +" Management Model in Patients with Gestational Diabetes Mellitus

目的探究基于标准化代谢性疾病管理中心(MMC)平台的“互联网+”管理模式在妊娠期糖尿病(GDM)患者中的应用价值。方法选取2019年5月至2020年2月在成都大学附属医院妇产科、内分泌科就诊的120例GDM患者为研究对象,按随机数字表法分为对照组和试验组,每组60例,对照组接受门诊常规产前指导与管理,试验组在此基础上应用基于MMC平台的“互联网+”GDM管理模式,比较两组管理前后代谢指标、妊娠结局、自我管理能力及心理状态的变化。结果管理4周后,两组空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)控制水平、焦虑评分均较管理前降低(P<0.05),且试验组低于对照组(P<0.05);两组自我管理各维度(GDM知识、态度/信念、社会支持、技巧/行为)评分及总分较管理前上升(P<0.05),且试验组高于对照组(P<0.05);试验组阴道分娩比例高于对照组(P<0.05);试验组胎膜早破、羊水过多、巨大儿、新生儿低血糖发生率均低于对照组(P<0.05)。结论基于MMC的“互联网+”管理模式可提高GDM孕妇血糖控制效果,改善母婴结局,提升孕妇自我管理能力,降低焦虑程度。

Objective To explore the application value of National Metabolic Management Center(MMC)platform-based"Internet+"management model in patients with gestational diabetes mellitus(GDM).Methods A total of 120 GDM patients treated in the department of gynecology and obstetrics,and the department of endocrinology of the Affiliated Hospital of Chengdu University from May 2019 to February 2020 were selected as the research objects.They were divided into control group(n=60)and experimental group(n=60)by random number table method.The control group was given routine prenatal guidance and management in outpatient clinics,while the experimental group was given MMC platform-based"Internet+"management model on this basis.Changes of metabolic indexes,pregnancy outcomes,self-management ability and psychological states before and after management were compared between the two groups.Results After 4 weeks of management,levels of fasting blood glucose(FBG),postprandial 2 h blood glucose(2 hPG),glycosylated hemoglobin(HbA1c)and triglyceride(TG)and anxiety scores in both groups were lower than those before management(P<0.05),and the above indicators in the experimental group were lower than those in the control group(P<0.05).The scores of each dimension of self-management(GDM knowledge,attitude/belief,social support,skills/behavior)and the total scores of self-management in both groups increased compared with those before management(P<0.05),and the above scores in the experimental group were higher than those in the control group(P<0.05).The proportion of vaginal delivery in the experimental group were higher than that in the control group(P<0.05).The incidence of premature rupture of membranes,polyhydramnios,macrosomia and neonatal hypoglycemia in the experimental group were lower than those in the control group(P<0.05).Conclusion MMC platform-based"Internet+"management model can improve the blood glucose control effect,the maternal and neonatal outcomes,the selfmanagement ability,and relieve the level of anxiety in GDM patients.