中国全科医学Issue(22)：2713-2717,2726,6.DOI:10.3969/j.issn.1007-9572.2015.22.022
社区“5+1”分阶段糖尿病达标管理模式对2型糖尿病患者的干预效果及其影响因素研究
Intervention Effect of Gommunity“5+1” Staged Diabetes Target Management Mode on Patients With Type 2 Diabetes Mellitus and Its Influencing Factors
摘要
Abstract
Objective To explore the intervention effect of community “5 +1” staged diabetes target management mode on patients with type 2 diabetes mellitus and its influencing factors .Methods In June 2011, we enrolled 2 621 patients with T2DM who accorded with the inclusion and exclusion criteria from 11 community health service centers administrated under Gulou District in Nanjing.After the exclusion of patients with incomplete data and with follow -up less than one year , we finally included 1 488 subjects.All patients were administrated with “5+1” staged diabetes target management , and the median time range for follow-up and intervention was 24 months.We collected data of subjects before intervention , at baseline , and during the first follow -up visit, the annual follow -up visit and the last follow -up visit.The data included general data , various metabolic indexes , treatment regimen , the usage rate of aspirin , the rates of blood glucose , blood lipid and blood pressure reaching standard, the detection rates of major metabolic indexes and screening rates for common complications .Results (1) HbA1c, FPG, 2 hPG, systolic pressure, diastolic pressure, TC, TG and LDL-C were lower (P<0.01) in the last follow-up visit than baseline , while BMI and HDL-C in the last follow -up visit were not significantly different ( P>0.05 ) from baseline.(2) Treatment regimen and the usage rate of aspirin in the last follow -up visit were significantly different ( P<0.01) from baseline.(3) There was significant difference (P<0.05) in the rate of blood glucose reaching standard among baseline , the first follow-up visit, the annual follow -up visit and the last follow -up visit; the rates of blood glucose reaching standard of the first follow-up visit, the annual follow-up visit and the last follow -up visit were significantly different ( P<0.008 3) from baseline.There was significant difference ( P<0.05 ) in the rate of blood pressure reaching standard among baseline , the first follow-up visit, the annual follow-up visit and the last follow -up visit; the rates of blood pressure reaching standard of the first follow-up visit, the annual follow -up visit and the last follow -up visit were significantly different (P<0.008 3) from baseline.There was no significant difference ( P>0.05 ) in the rate of blood lipid reaching standard among baseline , the first follow-up visit, the annual follow-up visit and the last follow -up visit.(4) There was significant difference (P<0.05) in the detection rates of HbA 1c , blood pressure and LDL-C among those before intervention , in the first follow-up visit and in the annual follow -up visit; there was also significant difference ( P<0.05 ) in the screening rates of urine A/C, eye ground , pedopathy and electrocardiogram.(5) The logistic regression analysis showed that the duration of diabetes , baseline HbA1c level, treatment regimen and expense type had significant influence (P<0.05) on intervention effect.Gonclusion Community“5 +1” staged diabetes target management mode has favorable intervention effect on T 2DM patients, and the duration of diabetes, baseline HbA1c level, treatment regimen and expense type are influencing factors for this effect .关键词
“5+1”分阶段糖尿病达标管理模式/糖尿病,2型/疾病管理/影响因素分析Key words
“5 +1” staged diabetes target management mode/Diabetes mellitus , type 2/Disease management/Root cause analysis分类
医药卫生引用本文复制引用
娄青林,陈吉海,代玲俐,庄永忠,许家仁,卞茸文,刘冬梅,欧阳晓俊,顾刘宝,俞匀,巫海娣,卢甜甜,胡艳..社区“5+1”分阶段糖尿病达标管理模式对2型糖尿病患者的干预效果及其影响因素研究[J].中国全科医学,2015,(22):2713-2717,2726,6.基金项目
国家自然科学基金面上项目（71373132）；江苏省基础研究计划（自然科学基金）重点项目 （）
