全科医生在社区糖尿病患者管理中的作用

Application of general practitioner in patients with diabetes in community

目的:探讨全科医生在社区糖尿病患者管理中的作用。方法:2013年2月-2014年6月收治糖尿病患者86例,随机分成观察组和对照组,各43例,对照组不进行追踪管理,只有在患者就诊时进行指导。观察组给予建立健康档案,实行分级管理,具体措施:建立健康档案,提供治疗方案,对于空腹血糖正常的患者每3个月随访1次,指导患者饮食、运动,随访时给患者检查血糖水平、糖化血红蛋白、尿微量蛋白和血压。对于空腹血糖<7.0 mmol/L的患者每1个月随访1次,对于空腹血糖>7.0 mmol/L的患者,1周随访1次,每个月检查血糖水平、糖化血红蛋白、尿微量蛋白和血压。指导患者养成良好的生活方式、健康饮食、合理运动,指导患者按时用药等。结果:两组患者体重指数比较差异无统计学意义(P>0.05),但是观察组血压、尿微量蛋白、空腹血糖、糖化血红蛋白和餐后2 h血糖明显低于对照组,两组比较差异有统计学意义(P<0.05)。结论:全科医生是社区糖尿病患者的健康卫士,对控制血糖有着重要的意义。

Objective:To investigate the role of general practitioners in the management of diabetic patients in community.Methods:86 patients with diabetic were selected from February 2013 to June 2014.They were randomly divided into the observation group and the control group with 43 cases in each.The patients of the control group did not track management,only were given guidance.The observation group were given to establish health files,implemented classification management.The specific measures included:establishing health files,providing treatment.Patients with normal fasting blood glucose were followed up for 1 time every 3 months,and were given the guidance of diet and exercise to patients.We checked the level of blood glucose,glycosylated hemoglobin,urine protein and blood pressure of the patients when follow-up.The patients of the fasting blood glucose<7.0 mmol/L were followed up for 1 time every 1 months;the patients of the fasting glucose>7.0 mmol/L were followed for 1 time every 1 week,and we checked the blood sugar level,glycosylated hemoglobin, urine protein and blood pressure every month.We guided the patients to develop a good way of life,a healthy diet,reasonable exercise,and guided the patients to take medicine on time and so on.Results:Body mass index of patients in the two groups showed no statistical significance(P>0.05),but the blood pressure,urine trace protein weight,fasting blood glucose,glycosylated hemoglobin and 2 h postprandial blood glucose of the observation group was significantly lower than those of the control group,and the difference of the two groups had statistical significance(P<0.05).Conclusion:The general practitioner is health guard for the diabetic patients in community,and they have important significance to control blood glucose.