Three Years Follow-up Study Of 208 Cases Of T2DM Patients With Hypoglycemic Scheme And Curative Effect In Shihezi Community

ObjectiveObservation of the hypoglycemic scheme and curative effect of 208 cases of patients of type 2 diabetes mellitus(T2DM)in Shihezi,Comparing the changes in themselves before and after,Comparing the factors that influence blood glucose to reach standard and comprehensive management status,which include Clinical outcomes and lifestyle and drug related situation.In order to lay the foundation for the implementation and formulation of "individualized" treatment plan,and provide reference for improving the management system of community diabetes standardization.MethodsIn 2015,208 cases of T2 DM patients were enrolled with complete data and conform to the standard in 2012.Using face to face communication,collecting their general information,medical history,lifestyle and behavior,and medication related information by questionnaires.Through blood test to detect blood glucose,blood lipid and other indicators and screen diabetic complications.According to the situation of drug treatment will be selected objects grouped by two different ways,the first type have five groups: lifestyle intervention group,oral drug group(oral drugs,oral two and two or more drugs),insulin group(group with insulin,insulin oral medications),namely three large groups and five small groups;The second type have three groups: oral drug treatment group,insulin treatment group,and combination therapy group.All data were set up with Epidata3.1 software to establish database and complete data entry.SPSS 20.0 software was applied to complete statistical analysis.Results(1)The composition ratio of hypoglycemic scheme: comparing the composition ratio of hypoglycemic scheme of three large groups in 2015 and 2012,208 cases of patients with hypoglycemic solution has 72.6% of patients remained unchanged consistently,there are differences between the change,up the ladder of treatments to patients with significantly more than the ladder to drop into treatment.In the oral drug group,21 percent became insulin groups,and 9 percent became a lifestyle intervention group.Twelve percent of the insulin group became the oral hypoglycemic group.(2)Five groups: In 2012 and 2015,the largest number of patients with a single oral dose of hypoglycemic drugs,accounting for 51.4% and 37% respectively in two years.Compared before and after two years,founding that compare with 2012,patients with oral drug in group2015 reduced 12.5%,the insulin treatment group increased 11%,among them mainly decline in oral drug treatment group,and rise in insulin combined oral drug group patients,P < 0.05,the difference was statistically significant.The glucose target rate of patients with drug oralgroup is highest in 2015 and in 2012,which respectively reach 49.2% and 48.1%.The glucose target rate with using of insulin group is the lowest,which has no statistical difference between group and group.(3)Compared with 2012,Biguanide,alpha-glucosidase inhibitors and insulin secreting agents were the most frequently used in 2015.And in 2015,the number of people using the beta-glucosidase inhibitor increased by 12%,and the DPP-4 inhibitors was added.(4)Three groups: The patients in the combination group were the oldest and the patients with the longest duration.The oral drug group was the youngest and the shortest course.Patients with insulin therapy group and combination group compared with oral drug treatment group,the success rate oral drug groups were higher,success rate of insulin treatment group were lower,comparison between three groups,2015 oral drug group success rate is higher than insulin group.(5)In 2015,the glycemic index rate was 41.2%,down from 45.3% in 2012(P > 0.05).In 2015,two categories of logistic regression analysis showed that the course of disease and complications were the risk factors affecting blood sugar to reach the standard,which dietary control,well medication compliance,and oral medication were the protect factors.Compared with 2012,the effect of triglyceride on blood sugar was reduced.Conclusions1.208 cases of T2 DM patients glucose-lowering solution composition ratio compared with 72.6% itself and unchanged consistently,P=0.001,clear up the ladder of treatments to patients than to drop step treatment.2.In 2015,208 cases of T2 DM patients with T2 DM had a 4.1% decrease in blood glucose levels compared with 2012.Consideration of course and complications is the main factor affecting the change.Thus,further improvement is needed to control blood glucose and blood lipid standards and delay its complications.3.Comprehensive management of diet control and enhance medication compliance a is an important strategy to improve the blood glucose level and delay the complications of T2 DM patients in shihezi community.