Evaluation Of The Effect Of Health Management On Elderly Patients With Type 2 Diabetes Mellitus In A Community Of Shenyang

Objective:To analyze and evaluate the effect of diabetes health management in community by analyzing and using the data of type 2 diabetes management in community basic public health service.To provide practical data and scientific basis for improving the quality of diabetes management in community.Methods:Among the 4258 chronic disease patients in a community hospital in Shenyang with cooperated with Shengjing Hospital Affiliated to China Medical University.184elderly T2DM patients who received health management in the community from 2018 to2019 were selected as the research subjects.The study method of self control before and after intervention was adopted.The intervention time was 1 year.The intervention methods included diabetes health lectures(around blood glucose monitoring,foot care,smoking cessation,alcohol restriction,etc.),diet control,medication guidance,sports health care,etc.Endocrinology experts from the Affiliated Hospital of China Medical University are regularly invited to provide on-site guidance and answer questions.Face-to-face or telephone follow-up every three months,with regular personalized instruction.Blood pressure,body mass index,blood glucose,blood lipids and levels,behavior improvement rate,diabetes complication screening rate were compared before and after intervention.If the data does not conform to the normal distribution,the quartile method is used to describe,and nonparametric rank sum test is used.The count data is expressed by rate,andX~2test is used.Results:(1)After the intervention,the body mass index,systolic blood pressure,fasting blood glucose and glycosylated hemoglobin levels were lower than those before intervention and the difference was statistically significant(P<0.05).After the intervention,triglyceride,total cholesterol and low density lipoprotein were lower than those before the intervention,and the difference was statistically significant(P<0.05).After intervention,HDL was higher than that before intervention,and the difference was statistically significant(P<0.05).There was no significant change in diastolic blood pressure after intervention(P=0.513).(2)The screening rate of microalbuminuria increased from 57.1%before intervention to 74.5%after intervention and the level of microalbuminuria decreased after intervention.The Electrocardiogram screening rate increased from 85.3%before intervention to 96.2%after intervention,and the differences were statistically significant(P<0.05).(3)There was no significant difference in the rate of behavior improvement between before and after the intervention on smoking(P=0.602)and drinking(P=0.672).There were significant differences in behavior improvement rate before and after the intervention in exercise(P<0.05)and medication compliance(P<0.05).Conclusion:The community health management for patients with type 2 diabetes was effective.After the intervention,the levels of body mass index,systolic blood pressure,fasting blood glucose,glycosylated hemoglobin,triglyceride,low density lipoprotein,total cholesterol and urinary microalbumin decreased compared with those before the intervention.The rate of microalbuminuria examination and electrocardiogram(ECG)examination were higher than those before the intervention,and the behavior of exercise and medication compliance were improved.Tobacco control and alcohol restriction were not significantly improved.