Research On The Application And Results Of Self-management Model On Type 2 Diabetes Patients In Urban Communities

Background: Type 2 diabetes is a lifelong chronic disease, once the disease is not only lethal, debilitating, but also to the patients and their families a heavy mental stress and financial burden seriously affect the quality of life in patients with family. Along with the increase of population aging process, particularly the elderly population growing tendency to aging, the prevalence of type 2 diabetes has gradually rise, and the government has given the community a heavy burden. Many domestic and international research shows that community-based, ongoing health promotion is to prevent and control diabetes, the best strategy. Late start of community prevention and control diabetes, current management can not meet all levels of the daily management of type 2 diabetes needs, management needs to further exploration. In this study, absorption of foreign communities in diabetes self-management model based on the successful experience, combined with the practical in Chongqing, China carried out in patients with type 2 diabetes self-management model applied research in urban communities, to explore a more suitable urban community daily in patients with type 2 diabetes demand management modelObjective: to compare the two different management mode for patients with type 2 diabetes, explore the effect of Chongqing real diabetes management mode.Objective: To compare two different management models on the daily management of patients with type 2 diabetes the effects of self-management of type 2 diabetes management in the community, the role and feasibility demonstrationMethods: To adopt a community-based field test group, in February 2009 -2 009 years in August Shapingba District in Chongqing City, selected economic conditions, demographic characteristics, health services in behalf of Chongqing urban communities through both the level of health development in the two health service centers, from the selected health service centers in the randomly selected one community health station as a research pilot, to mobilize the community through neighborhood health stations under the jurisdiction of the community in patients with type 2 diabetes to participate in this interference. The trial had taken 104 patients with type 2 diabetes, according to their community health stations were randomly divided into experimental and control group for 6-month intervention for the study, experimental group received self-management model management, control group patients according to the existing Chongqing Type 2 diabetes in community case management protocol, and received hierarchical management model management classification. End of the experiment, by comparing the two groups were enrolled, the intervention in 3 months, intervention at the end of knowledge in diabetes awareness, self-management level, depression, anxiety, and blood glucose, blood pressure, body mass index changes, and combine the two kind of management intervention in the management of costs and organize activities, self-management model to evaluate management effectiveness and feasibility.Results: 1,Self controlled: experimental group intervention and intervention 3 months 6 months compared with before intervention, patients with diabetes knowledge were significantly increased level of self-management (P <0.05), depression and anxiety symptoms are obvious improved (P <0.05), fasting glucose, postprandial 2h plasma glucose and glycosylated hemoglobin mean, the mean systolic blood pressure, body mass index were significantly decreased the mean (P <0.05), mean diastolic blood pressure decreased slightly, but no significant change (P> 0.05 ), fasting glucose, postprandial 2h plasma glucose, glycated hemoglobin compliance rate, blood pressure and compliance were significantly increased (P <0.05), body mass index standard rate rose slightly in the experimental group were the target intervention and intervention 3 months 6 months compared with the mean fasting blood glucose and significantly lower mean systolic blood pressure (P <0.05), no significant changes in other indicators; control group of patients 3 months after intervention and 6 months compared with before intervention, the mean score of diabetes knowledge there significantly increased (P <0.05), self-management score lower, depression, anxiety score increased, but no significant change (P> 0.05), fasting glucose, postprandial 2h plasma glucose, glycated hemoglobin mean value was significantly decreased, blood pressure and body mass index slightly have lower fasting and 2h plasma glucose, glycated hemoglobin was significantly increased compliance (P <0.05), blood pressure, body mass index standard rate has increased, the control group after the intervention of the indicators in patients 3 months and 6 months compared ratio, in addition to 2h postprandial blood glucose, mean glycated hemoglobin increased significantly, the no statistical significance (P> 0.05).2,Control groups: experimental group 3 months after the intervention, 6 months, the level of diabetes knowledge, awareness, self-management, as well as fasting and 2h plasma glucose, glycated hemoglobin, blood pressure, body mass index were significantly higher than compliance control group (P <0.05), depression, anxiety, improvement of symptoms was also significantly higher in patients (P <0.01), fasting and 2h plasma glucose, glycated hemoglobin were significantly higher than average patient; blood pressure, body weight index mean and the control group patients respectively.3,The cost of intervention: experimental group received follow-up guidance and psychological counseling and higher than the control group were 126 and 14 times respectively, to participate in health education programs and group activities were higher than the control group were 542 and 578 passengers, the cost of intervention than the control group increase of 16.2 yuan per person per month in patients.Conclusion: The results show that the self-management model in enhancing the urban communities of diabetes in patients with type 2 diabetes knowledge awareness, self-management level, improve depression, anxiety and diabetes control than hierarchical classification management, interventions to increase the cost of the limited . However, the limitations of this study, self-management model is to replace hierarchical classification of community management of patients with type 2 diabetes, daily management, the model needs to combine long-term effects and management on the effectiveness of different community groups and further discussed.