Effect Of Intensive Health Education On Blood Glucose Control And Its Influencing Factors In Patients With Type 2 Diabetes Mellitus

objective To investigate the effect of intensive health education on blood glucose control and its influencing factors in patients with T2 DM.To provide scientific basis for the selection and optimization of the intervention model of type 2 diabetes management and blood glucose control.methods1 Meta analysis of the effect of intensive health education on blood glucose control in patients with T2 DM Through the full text retrieval way,CNKI,VIP and Wanfang ?Pubmed?Ovid?Cochrane library database to collect all relevant documents from January 2011 to December 2016.According to inclusion and exclusion criteria,the related literatures were included in the Meta analysis model.Jadad scale was used to evaluate the quality of the article,and the relevant data were extracted and analyzed by Stata12.0 software.Hb A1 c,FPG and 2h PG were used as indexes,and WMD was used to analyze Meta.Using Cochrane Q test and I2 test for heterogeneity in size,when the P<0.05 or I2 >50%,using random effects model;when the P>0.05 or I2?50%,fixed effect model.At the same time,sensitivity analysis was performed.The funnel plot and Egger 's and Begg' s test were used to evaluate whether there was publication bias.Subgroup analysis was performed according to different subjects.2 Investigation on Influencing Factors of blood glucose control in T2 DM patients in urban communities A total of patients with T2 DM who were diagnosed in the resident population of a city were studied.On the basis of collecting the health records of diabetic patients in the community,the patients who met the inclusion criteria were investigated by questionnaire.After entering the questionnaire,SPSS20.0 software was used for statistical analysis.Univariate analysis using c2 test and non conditional Logistic single factor analysis;multivariate analysis using two Logistic regression analysis.results1 Meta analysis of the effect of intensive health education model on blood glucose control in patients with T2 DM In this study,Hb A1 c,FPG,2h PG value as indicators,were included in 45,43,and35 reports,were randomized controlled study.The heterogeneity of the three indexes were higher(I2>50% and P <0.05),which are using a random effects model,the results showed that the strengthening health education group on blood glucose control in patients with type 2 diabetes is better than that of the conventional education group,compared with the control group,strengthening health education can significantly reduce the patients with type 2 diabetes Hb A1c[WMD=-0.91%(95%CI:-1.12~-0.70)%],FPG[WMD=-1.21mmol/L;(95%CI:-1.45~-0.97)mmol/L],2h PG[WMD=-1.83mmol/L;(95%CI:-2.16~-1.50)mmol/L].The sensitivity analysis shows that the Meta model is stable.The funnel plot,Egger 's and Begg' s test were used to identify the publication bias,Hb A1 c and FPG were no indicators,but 2h PG was publication bias.Further to the hospital model,community model,joint model for hospital community groups,19,16,10 were included.in the literatures showed that different subjects of intensive health education intervention is effective on the control of blood glucose in T2 DM.With Hb A1 c as the index,compared with the control group: the hospital model reduces the[WMD=-0.84%;(95%CI:-1.11~-0.58)%];community mode reduced [WMD =-0.82%;(95%CI:-1.06~-0.58)%];the hospital community mode [WMD=-1.11%;(95%CI:-1.68~-0.54)%].With FPG as the index,compared with the control group: hospital mode to reduce the [WMD=-1.19mmol/L;(95%CI:-1.53~-0.86)mmol /L];community mode[WMD=-1.29mmol/L;(95%CI:-1.68~-0.90)mmol/L];the hospital community mode(WMD=-1.08mmol/L;[95%CI:-1.69~-0.48)mmol/L].With 2h PG as the index,compared with the control group: the hospital mode [WMD=-1.82mmol/L;(95%CI:-2.30~-1.34)mmol/L];community mode [WMD=-1.86 mmol/ L;(95%CI:-2.37~-1.35)mmol/L];the hospital community [WMD=-1.74mmol/L;(95% CI:-2.71~-0.77)mmol/L].In addition,the subgroup analysis was used to explore the heterogeneity of the sources,and the heterogeneity was not significantly reduced.2 Analysis of influencing factors of blood glucose control in T2 DM patients in urban community In this study,660 patients with type 2 diabetes mellitus were investigated,and the effective rate was 603,and the effective rate was 95.65%.The effective rate was 91.4%.The prevalence rate was 5.69%,and the control rate was about 58.97%.The effect of FPG intervention on patients with type 2 diabetes mellitus was significantly better than that of those without health education intervention(P<0.05).The health education of different intervention subjects had an effect on the control effect of FPG,c 2=13.556(95%CI:0.027~0.034),community,hospital,hospital community joint mode fasting blood glucose control rate were 55.50%,74.36%,74.71%.The mean value of fasting blood glucose control in community,hospital and hospital community was(7.36±2.05)mmol/L,(6.70±1.88)mmol/L,(6.68±1.57)mmol/L.The factors influencing fasting blood glucose control in patients with type 2diabetes mellitus were BMI,duration of disease,smoking and dietary factors(P <0.05).BMI abnormalities(OR=6.097,95%CI:2.590~14.352,P<0.05),smoking(OR=5.497,95%CI:2.718~11.119,P<0.05)were risk factors.The less attention to diet control,the worse the effect of blood glucose control;with the extension of the course of disease,the effect of blood glucose control is less obvious.The effect of BMI,exercise and treatment on fasting blood glucose control in hospital model(P<0.05).Diet,smoking and education level influenced fasting blood glucose control in community model(P<0.05).Diet was the influencing factor in the hospital community joint model(P<0.05).Conclusion1 strengthening health education among different intervention subjects has positive effects on glycemic control in patients with type 2 diabetes mellitus.2 health education of different intervention subjects may have different effects on glycemic control in patients with type 2 diabetes mellitus.Among them,hospital community combination model,hospital model and fasting blood sugar control effect are better than community model.3 different intervention subjects have different influence factors on glycemic control in patients with type 2 diabetes mellitus.