大连市社区2型糖尿病患者不同管理方式的效果评价

目的]探索社区2型糖尿病有效的管理模式，以便使糖尿病患者得到规范化管理，达到预防与控制糖尿病的目的。方法]2007年5月至2008年10月，在大连市西岗区石道街社区选取475例糖尿病患者进行为期18个月的健康管理，其中强化管理组（121例）实施3个月的量化饮食、运动干预指导．普通管理组（354例）实施普通健康管理。结果]管理前后强化管理组的体重均明显高于普通管理组（PdO．01）；管理后强化管理组糖化血红蛋白低于普通管理组（PdO．01），血糖、血压、血脂、低密度脂蛋白胆固醇管理前后2组问的差异均无统计学意义（P〉0．05）；管理后与管理前2组体重、血压的差异均无明显改善（P〉0．05）。结论]以社区为基础，由社区医生为患者提供日常的随访管理服务与病情监测，综合医院提供技术支持并为病情不稳定的患者提供个性化治疗方案的社区一医院一体化糖尿病管理模式，可以有效控制糖尿病患者的病情。

Evaluation on the Effects of Different Management on Diabetic Patients in Communities in Dalian

Objective]To standardize the regulation on the management of diabetic patients and to realize preventing and controlling diabetes, an effective management pattern for the diabetic patients in communities has been explored. Methods]The 485 diabetic patients were selected in Shidaojie Community of Xigang district of Dalian,and health management had been conducted for 18 months from May 2007 to October 2008. These diabetic patients were divided into 2 groups,strengthening group（121） and ordinary group（354）. For the strengthening group, 3 months quantified dietary intake and quantified exercise intervention were conducted, and for the ordinary group, usual health management were conducted. Results]After the experiments, the body weights of the strengthening group were obviously heavier than those of the ordinary group（ P 〈0.01）, and the blood glucose were lower（ P d0.01）. For the blood fat, blood pressure and HbAlc,LDL no significant difference could be found（ P 〉0.05）. There was no significant improvement on the difference of both body weight and blood pressure for the same groups（ P 〉0.05）. Conclusion]Based upon the follow-up and management provided by the community doctor and the technical support provided by the hospital, the integrated care management pattern is effective to control diabetes.