摘要
目的探讨协同糖尿病管理模式对糖尿病患者代谢指标的影响。方法选取2014年5月至2015年5月在该院起始基础胰岛素(INS)治疗的366例2型糖尿病(T2DM)患者,给予医生-护士-患者三者相互协同管理,以糖尿病治疗的5项基本措施为指导,结合饮食、运动、药物进行治疗,同时行自我血糖监测及糖尿病教育,共312例患者完成3个月随访,比较接受协同糖尿病管理前后各项代谢指标的变化情况。结果 312例完成随访的患者接受协同糖尿病管理后其空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平及收缩压均低于管理前,差异均有统计学意义(P<0.05);通过协同管理,74.8%的患者FPG水平达到医生设定目标,70.2%的患者FPG≤7.0mmol/L;随访3个月后完成管理组FPG达标率与未完成管理组比较,差异均有统计学意义(均P=0.001)。完成管理的患者FPG水平低于未完成者,差异有统计学意义(P=0.005)。结论医生-护士-患者三者协同的规范化糖尿病管理模式能够较好地控制患者的各项代谢指标,促进糖尿病患者的自我管理,对稳定血糖起到了良好的效果。
Objective To explore the effects of the doctor-nurse-patient based collaborative model of diabetes mellitus management on metabolism markers in patients with diabetes mellitus. Methods A total of 366 cases of patients with type 2 diabetes mellitus who started receiving insulin（INS）therapy in our hospital from May 2014 to May 2015 were selected,and were given doctor-nurse-patient based collaborative model of diabetes mellitus,including diet control, exercise control, drug therapy, diabetes education and self-monitoring of blood glucose. Among them, 312 cases of patients accomplished g-months follow-up. The levels of metabolism markers before and after accepting diabetes mellitus management were compared. Results After accomplishing 3 months diabetes management, the FPG, H bAlc,TC and LDL-C levels and SBP in the 312 cases of patients with diabetes mellitus were obviously lower than those before accepting management, the differences were statistically significant（P〈0.05）. After collaborative model of diabetes mellitus management,the level of FPG in 74.8% of patients was reached at the objective level set up by doctors, meanwhile that in 70.2% of patients was 7.0 mmol/L or less,there was statistically significant difference in the standard-reaching rate of FPG level compared with the patients who did not complete the management course（P= 0. 001）. The level of FPG in pa- tients who completed the entire management course was significantly lower than that in those patients who did not complete the entire management course, the difference was statistically significant（P= 0. 005）. Conclusion The doctor-nurse-patient based collaborative model of diabetes metlitus management can effectively control metabolism markers levels and stimulate self-management in patients with diabetes mellitus,which could paly an important role for stabilizing blood sugar.
出处
《重庆医学》
CAS
北大核心
2016年第35期4959-4962,共4页
Chongqing medicine
关键词
糖尿病
2型
协同管理模式
血糖
diabetes mellitus, type 2
collaborative management model
blood glucose
