血糖监测在上海农村社区糖尿病管理中的作用

摘要

目的 分析医院-社区一体化管理及血糖监测在糖尿病患者管理中的效果.方法 2014年4月～2015年4月对上海市某农村社区541例糖尿病患者实施1年的医院-社区一体化强化管理及血糖监测,并记录血糖、血压、血脂等指标,收集患者管理前后的临床及实验室资料并进行统计分析处理.结果 经过1年的管理后,糖尿病患者的糖化血红蛋白、空腹血糖、餐后2h血糖、胰岛素抵抗指数、收缩压、舒张压、三酰甘油、低密度脂蛋白胆固醇、腰围均较管理前显著下降,差异有统计学意义(P＜0.05).管理后,糖化血红蛋白、血压、血脂的达标率均较管理前提高,分别从63.40％ 、9.98％ 、50.46％提高到72.27％、22.18％、58.96％,差异有统计学意义(P＜0.05).管理后糖化血红蛋白、血压、血脂的单项、双项、三项达标率均较管理前显著提高,差异有统计学意义(P＜0.05).结论 提高糖尿病患者的血糖监测次数能对患者的血糖、血压、血脂的达标率产生积极影响.血糖监测是控制血糖一个好的管理措施,加强血糖监测是糖尿病慢病管理的一种有效方法,对上海农村郊区糖尿病患者的管理是重要的.%Objective To analyze the effect of hospital-community integrated management and blood glucose monitoring in the management of patients with diabetes mellitus.Methods Five hundred and forty-one patients with diabetes mellitus coming from one Shanghai rural community from April 2014 to April 2015 were applied with hospital-community integrated strengthening management and blood glucose monitoring for one year,and the indexes of blood glucose,blood pressure,blood lipid were recorded,the clinical and laboratory data before and after management was collected and taken statistical analysis.Results After management for one year,the glycosylated hemoglobin,fasting blood-glucose,two-hour postprandial plasma glucose,insulin resistance index,systolic blood pressure,diastolic blood pressure,triacylglycerol,low density lipoprotein cholesterin,waistline of patients with diabetes mellitus were all decreased compared with those before management,the differences were statistically significant (P ＜ 0.05).After management,the good control rates of glycosylated hemoglobin,blood pressure,blood lipid were all increased compared with those before management,which increased from 63.40％,9.98％,50.46％ to 72.27％,22.18％,58.96％ respectively,the differences were statistically significant (P ＜ 0.05).After management,the good control rates of single,two,three indexes of glycosylated hemoglobin,blood pressure,blood lipid were all increased compared with those before management,the differences were statistically significant (P ＜ 0.05).Conclusion Increasing the frequency of blood glucose monitoring for patients with diabetes mellitus can have a positive impact on the good control rates of blood glucose,blood pressure,blood lipid of patients.Blood glucose monitoring is a good management measure for controlling the blood glucose,strengthening the blood glucose monitoring is an effective method of chronic diseases management of diabetes mellitus,which is important for the management of patients with diabetes mellitus in Shanghai rural community.