Intervention Study Of Impaired Fasting Glucose On The Population Of Health Examination Of Western New City Of Chongqing

BackgroundIn1997, the World Health Organization (WHO) reported that there are about135million patients who are diagnosed with diabetes mellitus and this number was predicted tobe299million in2025worldwide.Nutrition Survey of China Residents in2010found thatthere were about40million diabetes mellitus patients at that year, and it has become anincreasingly serious public health problem. The Impaired Fasting Glucose (IFG) ones as inthe pre-diabetes mellitus(PDM）, could turn to normal blood glucose or diabetes or maintainbeing impaired fasting glucose.Surveys in many countries show that there is about21.16%to61.13%impairedfasting glucose (IFG) turning into the diabetes. So, the impaired fasting glucose ones arefaced with the high risk of diabetes patients, the consequences are serious. Studies haveshown that health interventions to the check-up ones for decrease of diabetes had effectcertainly. However, the current researchs of IFG in population of health examinationinclude influence factors, health hazard and theory of prevention method, lack ofintervention study in population of health examination. This study chose physicalexamination center as the research field, the crowd who had done the check-up in physicalexamination center of University Town Hospital of Chongqing Medical University asresearch object，adopted parallel controlled trial, analysis of epidemiological characteristicsof impaired fasting glucose in population of health examination，Evaluating the effect ofinterventions, establishing a set of suitable interventions of impaired fasting glucose forpopulation of health examination in China preliminarily.Subjects and MethodsThis research is the two sets of parallel controlled trial, to University Town hospitalaffiliated to Chongqing medical university health examination center as the study of the scene. Through the draw method makes units into the different intervention groups andcontrols group respectively. In2013, the baseline survey of chosen population of healthexamination has been done. After that, the intervention group received health education andbehavior intervention in life while the control group just gave normal management for1year. Medical people live in routine health and the intervention time is1year. Allinterventions carried out by trained doctors. Intervention is divided into two stages. Thefirst stage is health education of prevention and cure of diabetes for9months. In the secondstage, strengthen intervention implementation of the risk of diabetes in medium-term byfollow-up way with phone and the last survey will be done for all research object at last.Measurement indicators include: general situation (gender, age, marital status, income,educational level, etc.), Check-up indicators (height, weight, BMI, fasting blood glucose,blood pressure, total cholesterol, triglycerides, LDL-C, HDL-C), and Habits (smoking,alcohol consumption, intake of fruits and vegetables, movements and so on).ResultsThere are1267(47.59%) as the object in the Baseline study, including603peoplefrom enterprise unit while664from business unit (52.41%). Average ages are42.62and12.38and there are350(27.63%) male and917(72.37%) female. Baseline survey showedthat the rate of impaired fasting glucose is28.47%(1423/4998), the average blood glucoselevel for impaired fasting glucose is (5.96+0.30) mmol/L, and the one of female is higherthan male. Fasting blood glucose value showed a trend of rising with the age increase (p <0.05).One year later, analysis of1027patients included533in the intervention group and494in control group. There was no statistically significance at baseline between controlgroup and intervention group（t=1.775,P=0.076）。After1year’s intervention and correction related influencing factors, the average levelof the intervention group of fasting glucose is low to the baseline tendency for0.40mmol/L(95%CI:-0.48,-0.18), while the control group increased tendency for0.08mmol/L (95%CI:-0.13,0.07), the control group decreased more than intervention group, the differencebetween two groups was statistically significant; Routine physical indicators uric acid, SBP,DBP, total cholesterol, BMI in intervention group were decreased respectively34.88mmol/L (95%CI:-39.23,-26.53),10.64mmHg (95%CI:7.24,-4.85),2.90mmHg (95% CI:-4.45,-2.61),0.32mmol/L (95%CI:0.42,-0.24) and0.50kg/m2(95%CI:-0.65,-0.44),while the control group SBP, DBP, BMI respectively11.02mmHg (95%CI:5.09,7.30),2.84mmHg (95%CI:2.18,3.76),0.57kg/m2(95%CI:0.32,0.49),uric acid, totalcholesterol decreased tendency for1.42/L (95%CI:-7.36,9.82),0.08mmol/L (95%CI:-0.13,-0.02), in addition to LDL-C and HDL-C cholesterol and triglycerides, statisticallysignificant difference between the two groups.After1year’s Intervention and correction related influencing factors, effect ofevaluation of life behavior intervention showed that in addition to smoking and drinking,low oil, limit salt diet, regular intake of vegetables, fruit and a moderate amount of sports inthe incidence of intervention group were higher than control group (p <0.005).After the intervention, impaired fasting glucose in diabetes of population of healthexamination is73, the rate of the probability was0.071per person/year, new diabetesmellitus in intervention group was(0.041/year) which was lower than the control group(0.103/year), control the related influence factors analysis, adjusted HR=0.36,95%CI:0.15~0.83, P=0.002).Conclusion(1) Health interventions could slow the rise of the risk of diabetes for the impairedfasting glucose for the people of physical examination;(2) Health interventions can reduce the routine examination index, uric acid, bloodpressure, total cholesterol, and fasting glucose, BMI, and reduce the incidence of adversehealth behaviors;(3) Health intervention can reduce the impaired fasting glucose of patients with type2diabetes mellitus effectively.