| Objective: To study the effect of joint prevention and treatment on fasting and postprandial blood glucose,blood pressure,blood lipid and islet function;and on the blood glucose,blood lipid,blood pressure,body mass control compliance rate,self-management ability and complications of patients with type 2 diabetes mellitus in three-tier integrated model.Methods: Select 264 patients with type 2 diabetes mellitus patients in Shinan District Hospital of Qingdao city from January 1,2015 to March 1,2015 as the research object.They were randomly divided into control group(n=130)and study group(n=134),Patients in study group were managed by a community-secondary hospital-tertiary hospital integrated system.the control group were not.Two groups of patients were tested blood glucose.Blood lipids.Insulin and C peptide at 3 months.6 months.9 months and 12 months respectively.And evaluation of diabetic complications.The results of fasting,postprandial blood glucose,blood pressure,blood lipid.glycemic control compliance rate,blood pressure control compliance rate,blood lipid control compliance rate,body mass index,control compliance rate,self-management ability score and patient referral rate islet functionwere compared between the two groups after the observation of 3,6,9 and 12 months,respectively.The incidence of diabetic complications in two groups was evaluated,The results of the observation group were compared with those before management.Results:(1)The observation group of patients with[fasting blood glucose(6.65 ± 0.46)vs(7.65 ± 1.28)mmol/l,postprandial blood glucose(7.66 ± 0.56)vs(9.08± 0.87)mmol/l],[TG(1.47 ± 0.76)lipid vs(1.74 ± 0.79)mmol/l],[TC(4.69 ± 0.83)vs(5.57 ± 1.15)mmol/l],[LDL-C(2.41 ±0.65)vs(2.97 ± 0.77)mmol/l],blood pressure,systolic blood pressure(130.30 ± 10.69)vs(138.58± 15.95)mm Hg,diastolic blood pressure(82.99 ±4.82)vs(88.54± 9.01)mm Hg],Hb A1 c [(6.87 ± 0.39)vs(7.54 ± 0.81)% ]and other indicators were significantly lower than the control group(P < 0.05).(2)The observation group patients with islet function of islet beta cell insulin [C peptide to replace the evaluation function(1.82 ± 0.17)vs(1.59±0.23)] and self management ability score [(17.44 ± 2.91)vs(6.80±2.14)%] was higher than that in control group(P <0.05).(3)The observation group patients blood glucose control rate(66.4%vs22.3%),blood lipid control rate(26.1%vs9.2%),body mass index control rate(34.3%vs20.0%)were higher than control group(P < 0.05);The blood pressure compliance rate of the observation group were higher than those in the control group(25.4%vs17.7%),but there was no significant difference between the two groups(P > 0.05).(4)patients in the observation group were significantly improved compared with before treatment,and the difference was statistically significant(P <0.05).(5)the incidence of diabetic complications in the observation group and the control group at the end of treatment was 37.3% and 51.5%,respectively,Diabetic complications in the control group were significantly higher than those in the observation group;The referral rates in observation group and control group were 40.3% and 22.3%,respectively.Conclusions:(1)The three-tier integrated model has a positive effect on fasting and postprandial blood glucose,blood pressure and blood lipid in patients with type 2 diabetes mellitus.(2)The management has a significant effect on improving the islet function,self-management ability score,blood glucose,blood lipid,blood pressure and other indicators of patients with type 2 diabetes.(3)management plays a positive role in preventing and reducing the occurrence and development of diabetic complications. |
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