不同病程的2型糖尿病患者经标准化代谢性疾病管理后的代谢指标转归

目的:探讨不同病程的2型糖尿病患者在接受标准化代谢性疾病管理1年后，其糖脂代谢相关指标转归及达标情况。方法:(1)将2017年9月至2018年9月在上海市第一人民医院国家标准化代谢性疾病管理中心(MMC)的345例2型糖尿病患者纳入研究，根据患者病程，分为新诊断2型糖尿病组(病程≤1年)和长病程组(病程>1年)，比较2...

Metabolic outcomes of type 2 diabetes patients with different diabetic durations under the standardized metabolic disease management model

Objective To explore the metabolic outcomes of type 2 diabetes patients with different durations after 1 year treatment under the standardized metabolic disease management model.Methods(1)From September 2017 to September 2018,345 type 2 diabetes patients in the Standardized Metabolic Management Center(MMC)of Shanghai General Hospital were recruited and included in this research.They were divided into newly-diagnosed type 2 diabetes(duration≤1 year)and long-term groups(duration>1 year).The general characteristics,blood pressures,glycemic levels,lipids levels,control rates and comprehensive compliance rates(blood glucose,pressure and lipids all reached targets)were compared at baseline between 2 groups.(2)All patients underwent one year standardized management,and metabolic indicators mentioned above and control rates at the time were compared as well.Results(1)At baseline,compared with long-term group,patients in newly-diagnosed type 2 diabetes group were younger(P<0.01),and 2 h blood glucose level after glucose loading were higher(15.20±5.26 vs 13.68±4.94)mmol/L,P<0.01].(2)After one year standardized management,body weight,blood pressure,glucose and lipids metabolism in all patients were significantly improved.Compared with patients in long-term group,newly-diagnosed type 2 diabetes patients achieved better glycemic levelfasting blood glucose(6.27±1.56 vs 7.63±2.08)mmol/L,P<0.01;glycated hemoglobin(6.33±0.96 vs 7.23±1.37)%,P<0.01],and had higher HOMA-β(74.01±56.45 vs 40.17±37.07)%,P<0.01].The glycemic control,blood pressure and blood lipids control rates in both groups increased significantly in one year.Comprehensive compliance rate of the whole patients increased from 5.80%to 24.06%.The metabolism indexes of the newly-diagnosed type 2 diabetes group were better than those of the long-term groupcomprehensive compliance rate:(24.73%vs 17.18%,P=0.087,glycemic control rate(84.62%vs 53.37%,P<0.01)].Conclusion Standardized metabolic disease management promoted the overall improvement in blood glucose,blood pressure,and lipids levels in type 2 diabetes patients,especially in terms of blood glucose and those of the newly-diagnosed type 2 diabetes.In the future,we should focus on the early diagnosis and treatment of type 2 diabetes,actively promote the MMC model and stress the integrated management of blood glucose,blood pressure,and blood lipid levels.We should pay more attention to the long-term patients,to improve their awareness and treatment compliance.