Comparison Of Metabolism Indexes After Systematic Standardized Management Of Diabetes Mellitus

Objective:To explore the mode of systematic standardized management of diabetic patients,and the effectiveness of the model on blood glucose,blood lipid,blood pressure and other indicators.Methods:137 patients with type 2 diabetes were selected as the research objects from September 2016 to September 2017 in People’s Hospital of liaoning Province.According to the random number table method,they were divided into control group(n=68)and management group(n=69).The control group was the routine treatment group.When in hospital,patients were routinely given diet,exercise guidance,training blood glucose meter,insulin pen usage and insulin injection site to make the blood sugar monitoring value and insulin injection of the patient more accurate,and popularize hypoglycemic symptoms and emergency treatment measure.After the patient was discharged from hospital,he would come to the hospital regularly to review relevant indexes.Self-management of blood glucose was carried out by patients after discharge from hospital.On this basis,the management team would carry out systematic and standardized management.Endocrine doctors would establish disease management files for each diabetic patient.Before discharge from hospital,a doctor-patient WeChat group was established.Telephone follow-up after discharge,individual management was carried out according to disease files,self blood glucose monitoring conditions,daily diet,exercise,emotion and other information of the patient.And timely communicate with patients and their families,enhance patients’ confidence in the face of disease,and establish the relationship between doctor and patient.Both groups of patients were managed for 6 months,The changes of fasting blood glucose(FPG),2-hour postprandial blood glucose(2hPG),glycosylated hemoglobin(HbA1c),body mass index(BMI),blood lipid,blood pressure and other metabolic indexes were measured and the compliance rates of FPG,HbA1 c,blood lipid and blood pressure were compared between the two groups.According to the baseline HbA1 c of themanagement group,it was divided into three groups,which less than 6.5% is one group,6.5%-8.5% is another group,and more than 8.5% is the last group,respectively to compare the management effects among the three groups Results : The baseline metabolic indexes of the two groups were compared: age(59.37±11.13 vs.59.76±11.88,p > 0.05)year,course of disease(10.41±8.36 vs.10.53±6.59,p > 0.05)year,FBG(9.44±3.49 vs.8.70±3.35 p > 0.05)mmol/L,2hPG(12.97±4.37 vs.12.38±4.44 p>0.05)mmol/L,HbA1c(8.2 0±1.93 vs.8.24±1.78 p>0.05)%,BMI(26.28±3.72 vs.26.07±3.31 p > 0.05)kg/ ㎡,TG(0.35±0.36 vs.0.32±0.18 p>0.05)mmol/L,CHO(5.03±1.16 vs.4.78±0.99 p>0.05)mmol/L,LDL-C(2.98±0.95 vs.2.86±0.81 p>0.05)mmol/L,HDL-C(1.18±0.30 vs.1.01±0.31 p>0.05)There was no statistical significance.After 6 months of management,FBG,2hPG,HbA1 c,TG were compared between the mana gement group and the control group(8.10±2.54 vs.9.72±3.84 p < 0.05)mmol/L,(10.04 ±3.08 vs.12.72±4.74 p < 0.05)mmol/L,(7.50±1.42 vs 8.24±1.69 p<0.05)%,(0.30±0.06 vs.0.37±0.31 p<0.05)mmol/L,The difference was statistically significant.The control compliance rates are as follows 4.4mmol/l<FPG<7.0mmol/l、HbA1c<7.0%、TG<1.7mmol/l、CHO<4.5mmol/l 、 LDL-C < 2.6mmol/l(Non-Coronary Heart Disease Patients),BP <140/90 mmHg.After management,the compliance rates of FBG,HbA1 c and TG between the two groups were compared(40.57 vs.23.53 % p < 0.05),(44.92 vs.23.53 % p < 0.05),(53.62 vs.41.17 % p < 0.05),The difference was statistically significant.According to the baseline HbA1 c of the management group,Group hemoglobin according to baseline management group,of which < 6.5% is one group,6.5%-8.5% is another group,and > 8.5% is the last group.Before and after the management the HbA1 c were respectively(5.99±0.36 vs.6.08±0.57)%,p> 0.05,(7.54±0.65 vs.7.30±0.99)%,p>0.05,(10.15±1.68 vs.8.52±1.46)%,p<0.05.Conclusion : 1.Systematic and standardized management can improve the blood glucose compliance rate and reduce the related indexes of blood lipid.Long-term implementation will improve the prognosis of diabetic patients 2.To discuss the groups that should be paid attention to in the management of diabetic patients.Effective intervention in the early stage can delay the progress of blood sugar.3.The compliancerates of HbA1 c,FPG and TG have increased,but the rate is not high.More effective methods can be further explored.