【摘要】：目的探討社區(qū)慢性病管理對糖尿病(DM)前期(PDM)患者糖代謝指標(biāo)的改善作用及其臨床價值。方法 2011年6月至2012年5月篩選本社區(qū)被診斷為PDM前期440例,按隨機(jī)數(shù)字表分為觀察組和對照組,每組220例。觀察組進(jìn)行社區(qū)慢性病管理,對照組患者采用常規(guī)社區(qū)管理。每月檢測患者糖代謝指標(biāo)、體重和健康知識知曉率,每3個月檢測糖化血紅蛋白、血脂、尿微量白蛋白、心電圖,每半年進(jìn)行眼底檢查、頸動脈彩超檢查,記錄患者DM進(jìn)展情況。并錄入健康檔案,連續(xù)觀察3年。結(jié)果觀察組各方面知曉率建檔前后比較差異顯著(P0.05),且均高于對照組(P0.05)。建檔后,兩組患者空腹、餐后2 h血糖均比建檔前降低,且觀察組降低水平優(yōu)于對照組(P0.05)。觀察組進(jìn)展為2型DM(T2DM)例數(shù)、眼底異常例數(shù)和心電圖異常例數(shù)均明顯低于對照組(P0.05)。結(jié)論社區(qū)慢性病管理可提高PDM患者的健康知曉率和血糖控制的效果,降低其進(jìn)展為DM的發(fā)生率,是社區(qū)防治DM簡單、有效、易行的重要方法。
[Abstract]:Objective to investigate the effect and clinical value of community chronic disease management on the improvement of glucose metabolism in patients with diabetes mellitus (DM) preterm (PDM). Methods from June 2011 to May 2012, 440 cases of PDM in our community were selected and randomly divided into observation group and control group with 220 cases in each group. Chronic disease management was carried out in the observation group and routine community management was used in the control group. Glucose metabolism index, body weight and knowledge rate of health were detected every month, glycosylated hemoglobin, blood lipid, urine microalbumin, electrocardiogram were detected every 3 months, fundus examination was carried out every six months, carotid artery color Doppler examination was performed. The progress of DM was recorded. The health records were recorded and observed for 3 years. Results there were significant differences in the awareness rate between the two groups before and after filing (P0.05), and were higher than those in the control group (P0.05). After filing, the fasting and 2 h postprandial blood glucose levels in the two groups were lower than those before the filing, and the decreasing level in the observation group was better than that in the control group (P0.05). The number of cases with type 2 DM (T2DM), abnormal fundus and abnormal ECG in the observation group were significantly lower than those in the control group (P0.05). Conclusion the management of chronic diseases in community can improve the health awareness rate and the effect of blood glucose control in PDM patients, and reduce the rate of progression to DM. It is a simple, effective and easy method to prevent and treat DM in community.
【作者單位】： 新疆奎屯市兵團(tuán)第七師醫(yī)院預(yù)防保健科;新疆奎屯市兵團(tuán)一二三團(tuán)疾控中心;
【分類號】：R587.1

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