论文部分内容阅读
目的探讨肥胖因素对社区2型糖尿病患者的综合干预的影响。方法遵循患者自愿参加的意愿,2008年到本社区中心就诊的2型糖尿病患者172例,在合理药物治疗的基础上,结合健康教育、定期复查及生活方式等强化干预方式,进行为期3年的干预。并定期对所有2型糖尿病患者的体质指数(BMI)、血压、血脂、空腹血糖、餐后2 h血糖、糖化血红蛋白(HbA1c)、肝肾功能等指标进行监测和记录。结果①T2DM合并肥胖患者的BMI、腰围、糖化血红蛋白比非肥胖患者水平高,高密度脂蛋白比非肥胖患者低,差异有统计学意义(P<0.05);②校正年龄、性别的影响,Logistic分析显示肥胖患者发生空腹血糖、糖化血红蛋白控制未达标的风险分别是非肥胖者的2.31倍(95%CI:1.12~4.78),1.98倍(95%CI:1.07~3.68);③T2DM肥胖患者干预后的体质指数、收缩压、糖化血红蛋白低于干预前,高密度脂蛋白高于干预前,差异有统计学意义(P<0.01);④GLM分析显示,BMI影响空腹血糖、糖化血红蛋白、高密度脂蛋白的干预效果,差异有统计学意义(P<0.05)。结论肥胖因素可能影响糖尿病患者的干预效果,通过社区长期强化管理,并有针对性对肥胖因素进行干预,可能有利于社区T2DM患者的管理效果。
Objective To investigate the effect of obesity on community-based comprehensive intervention in type 2 diabetes. Methods According to the willingness of patients to participate voluntarily, 172 patients with type 2 diabetes who visited the community center in 2008 were enrolled in this study. On the basis of rational drug treatment, combined with intensive intervention such as health education, regular review and lifestyle, Intervention. The body mass index (BMI), blood pressure, blood lipid, fasting blood glucose, postprandial 2h blood glucose, HbA1c, liver and kidney function and other indicators were regularly monitored and recorded in all type 2 diabetic patients. Results ① The BMI, waist circumference and HbA1c of T2DM patients with obesity were higher than those of non-obese patients, and the levels of HDLs were lower than those of non-obese patients (P <0.05) .②The influence of age and gender was adjusted by Logistic analysis The risk of non-compliance of HbA1c in patients with obesity was 2.31 times (95% CI: 1.12 ~ 4.78) and 1.98 times (95% CI: 1.07 ~ 3.68), respectively. Index, systolic blood pressure, HbA1c before intervention were higher than before intervention, the difference was statistically significant (P <0.01); ④GMM analysis showed that BMI influence the intervention of fasting blood glucose, glycosylated hemoglobin and high density lipoprotein The difference was statistically significant (P <0.05). Conclusions Obese factors may affect the intervention effect of diabetic patients. Long-term intensive management of community and targeted intervention of obesity may be beneficial to the management of T2DM patients in community.