Study On The Comprehensive Control Status Of T2DM Patients And The Intervention Effect Of Information-based Hierarchical Diagnosis And Treatment Model

Objectives 1.Investigate the comprehensive control situation and dietary intake status of T2DM hospitalized patients,and analyze the effect of dietary mode on the control effect of T2DM patients.2.Explore the control effect of information-based hierarchical diagnosis and treatment management mode on T2DM.Provide a reference for improving the comprehensive blood glucose control status of T2DM patients,and a reference for establishing a basic diagnosis and treatment model of grassroots diabetes suitable for China's national conditions.Methods 1.From March to November 2019,investigate the basic information,physical fitness,biochemical indicators and dietary status of T2DM inpatients in Lanzhou and Longxi County.The comprehensive control situation and dietary pattern of T2DM hospitalized patients were analyzed,and the influence of dietary pattern on the control effect of T2DM patients was analyzed by Logistic regression model.2.The information~based hierarchical diagnosis and treatment model intervention research in Wenfeng Town and Longxi County were carried out.T2DM patients were divided into control group and observation group.The patient's physique and related disease indicators were detected,and self-management was done through questionnaire Evaluation of behavior and drug dependence,after a year of intervention.The t-test,non-parametric test and?~2 test were used to evaluate the impact of the information~based grading diagnosis and treatment mode on BMI,blood pressure,blood glucose,blood lipid control,hypoglycemia,self~management ability,and drug dependence in T2DM patients.Results 1.Comprehensive control status of T2DM patients:(1)A total of 542valid questionnaires were recovered,of which 249 were from Lanzhou and 293 were from Longxi County.The subjects'blood pressure,BMI,FPG,HbA1c,blood glucose,TC,TG,LDL-C,HDL-C,and blood lipid compliance rates were 28.7%,40.6%,29.2%,32.0%,16.2%,58.8%,and 55.0%,respectively,46.7%,47.7%,and 15.6%;the ABC compliance rate was 4.1%;BP,BMI,blood glucose,and blood lipids all met the standards of 2.2.%;4.4%of patients did not meet all standards.(2)The average daily intake of cereals,vegetables,fruits,livestock,poultry,aquatic products,eggs,milk,soy products and nuts were 363.47g,331.87g,and 113.65g,78.26g,13.77g,41.33g,115.06g,19.71g,and 14.46g.Insufficient and excessive intake of various foods coexist.Five types of dietary patterns were extracted through factor analysis,including livestock and poultry aquatic meat,egg milk,nut snacks,cereals,and tea pickles.1.3 Relationship between dietary pattern and control status of T2DM patients.(3)Logistic regression analysis showed that livestock and poultry aquatic products(FPG:OR=2.054,95%CI:1.080,3.904;HbA1c:OR=2.927,95%CI:1.189,7.208)and tea drink pickles diet pattern(FPG:OR=2.633,95%CI:1.417,4.891)is good for blood glucose control in T2DM patients.However,the egg milk(FPG:OR=0.413,95%CI:0.210,0.813),nut snacks(HbA1c:OR=0.436,95%CI:0.204,0.932)and cereals(FPG:OR=0.520,95%CI:0.283,0.957)are not conducive to blood glucose control for patients.Nut snacks(TG:OR=1.863,95%CI:1.008,3.442;HDL-C:OR=2.748,95%CI:1.332,5.671;Blood lipid:OR=2.976,95%CI:1.154,7.671)and cereal diet pattern(LDL-C:OR=2.806,95%CI:1.378,5.712)is helpful for the reasonable control of blood lipids in patients with T2DM.While the dietary pattern of livestock and poultry aquatic products is not conducive to the control of HDL-C(OR=0.369,95%CI:0.184,0.741).The multivariate regression analysis of the remaining dietary patterns between normal person and patients with T2DM showed no statistical significance.2.Intervention effect of information~based grading diagnosis and treatment model:After a year of information~based grading diagnosis and treatment intervention,the levels of HbA1c,FPG,and LDL-C in the observation group decreased,and the HDL-C levels increased(P<0.05).After the intervention,the FPG compliance rate of the two groups increased significantly.The proportion of HbA1c in the observation group that failed to meet the target before the intervention was higher than that of the control group(17.1%vs 11.6%,P=0.020).After the intervention,the self-management behavior of T2DM patients did not change significantly,but their health status and drug dependence were improved.Conclusions 1.The comprehensive control situation of T2DM patients in Lanzhou and Longxi County are not optimistic.The various types of food intake and over-exposure are co-existing.The factor analysis showed that co-existence of five dietary patterns are closely related to blood glucose and lipid control status in T2DM patients.2.The management of information-based classification diagnosis and treatment mode are helpful for the effective control of blood glucose,diastolic blood pressure,low-density lipoprotein and high-density lipoprotein in diabetic patients,thus can improve the patient's health status and drug dependence.