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目的观察社区随访新模式对2型糖尿病(T2DM)患者血糖和代谢指标的影响。方法T2DM患者240例随机均分成传统社区随访(A)组、联合随访(B)组及中心随访(C)组。随访3、6个月后,评估三组血糖、血压、血脂及低血糖事件发生情况。结果本研究共228例完成随访,失访11例,退出研究1例。与出院时比较,随访3个月后,B、C组患者HbA1c、FBG、餐后2h血糖、TC、TG、LDL-C及BP降低(P<0.05),而A组无明显变化(P>0.05)。随访6个月后,A组患者HbA1c、餐后2h血糖、TC、TG及BP较出院时降低(P<0.05),而FBG和LDL-C无明显下降(P>0.05)。A、B、C组分别有10、5、2例发生低血糖事件,组间比较差异有统计学意义(P<0.05)。结论内分泌专科医生指导下的社区随访新模式可以更有效地控制T2DM患者的血糖、血压和血脂,减少低血糖事件的发生。
Objective To observe the effects of a new community follow-up on blood glucose and metabolic parameters in patients with type 2 diabetes mellitus (T2DM). Methods A total of 240 patients with T2DM were randomly divided into two groups: traditional community follow-up (A), combined follow-up (B) and central follow-up (C). After 3 months and 6 months follow-up, the incidence of blood glucose, blood pressure, blood lipids and hypoglycemia were evaluated. Results A total of 228 cases were followed up in this study, 11 cases were lost and 1 case was withdrawn from the study. Compared with those at discharge, the levels of HbA1c, FBG, 2h postprandial blood glucose, TC, TG, LDL-C and BP decreased in group B and group C after 3 months of follow-up (P < 0.05). After 6 months of follow-up, HbA1c, 2h postprandial blood glucose, TC, TG and BP in group A were lower than those at discharge (P <0.05), but no significant decrease in FBG and LDL-C (P> 0.05) There were 10, 5 and 2 hypoglycemic events in group A, B and C, respectively, with significant difference between the two groups (P <0.05). Conclusion The new model of community follow-up under the guidance of endocrinologists can control blood sugar, blood pressure and blood lipid in T2DM patients more effectively and reduce the occurrence of hypoglycemic events.