| Objective: The purpose of this study was to investigate the health management status of type 2 diabetes mellitus patients in Jining Zhonghe community health service centers. At the same time, 906 patients with clinical pathway management of type 2 diabetes were followed up regularly. We evaluated the efficacy of this community diabetes management. To provide suggestions and countermeasures for the further improvement of community type 2 diabetes mellitus.Methods: In this study, a systematic sampling method was used to investigate the prevalence of type 2 diabetes mellitus patients in Jining Zhonghe community service center from October 2014 to January 2015. A total of 906 patients entered the study cohort. Blood glucose, blood lipids,glycosylated hemoglobin, body mass index, blood pressure, exercise and other data of the patients were collected, and the health management status of the community type 2 diabetes mellitus was analyzed. All enrolled patients are type2 diabetes clinical pathway standardized management. The patients were followed up for 1 year after observation of the indicators for monitoring changes in the situation, evaluate the effect of clinical pathway management in type 2 diabetes in the community, and to analyze its influencing factors.Results: 1. Management status of patients with type 2 diabetes in community 1) Fasting blood glucose(FPG), blood pressure compliance ratewere 70.97%, 83.88%. Body mass index(BMI), waist circumference and Hb A1 c not up to standard rate were 41.94%, 61.15%, 62.91%. 2) Community patients with type 2 diabetes, according to the basic situation of the age, the course of disease and medication situation were stratified after the analysis,found that 60 years old the following population FPG, diet control are poor(P<0.05). The patient’s systolic blood pressure increased with the course of disease(P<0.05). Along with the change of the hypoglycemic plan, increased in the types of hypoglycemic drugs, Hb A1 c has an increased trend(P<0.05). 2.Follow up of T2 DM patients after path management. 1) After one year of intervention in patients with type 2 diabetes mellitus. Hb A1 c, FPG, HDL-C,LDL-C, SBP, BMI, waist circumference, regular exercise, diet control,psychological adjustment and drug use were all improved significantly(P<0.05). 2) Community diabetes management effect evaluation and influencing factors analysis, Hb A1 c as the main evaluation criteria of community diabetes management effect, FPG as a secondary evaluation standard, the two were significantly decreased compared with the previous.Hb A1 c control as a result of variables, diet, exercise, psychological adjustment and medication is beneficial to the control of blood glucose in community patients with type 2 diabetes mellitus. 3) After adjustment, the implementation of community diabetes clinical pathway management of blood sugar compliance rate is 2.02 times before management(OR=2.02, 95%CI: 1.29~3.17,P-value is 0.0022). Path management after the Hb A1 c value than before theimplementation of the path to reduce 0.84%,(β=-0.84, 95%CI:-1.12~-0.55,P-value is <0.0001). The FPG value of the intervention was lower than before the intervention of 0.9mmol/L,(β=-0.90, 95%CI:-1.25~-0.55, P-value is<0.0001).Conclusions: The community glucose control compliance rate is low, after the standardized management of clinical path, compliance rate of blood glucose-control was significantly higher than before. After the community clinical pathway management, FPG, Hb A1 c compared with the former has improved significantly. The above indicates that the management path intervention is effective. |
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