联合营养团队的程序化随访在2型糖尿病患者中的应用

目的探讨联合营养团队的程序化随访对2型糖尿病患者随访管理的效果,为临床提供实践依据。方法采用便利抽样法,选择2016年3月—2017年12月在新疆医科大学第一附属医院糖尿病专科随访门诊就诊的2型糖尿病患者144例,应用联合营养团队的程序化随访进行前瞻性观察,完成2年随访后采用重复测量方差分析比较基线、第12个月、第24个月患者肥胖、血糖、自我管理行为的变化。结果最终141例患者完成2年随访,第24个月时141例患者BMI(21.73±1.89)kg/m2,腰围(77.57±1.68)cm,腰臀比(0.87±0.04),空腹血糖(5.14±0.92)mmol/L,糖化血红蛋白(5.27±0.73)%,总胆固醇(3.92±1.67)mmol/L,甘油三酯(1.94±0.68)mmol/L,低密度脂蛋白(1.04±0.31)mmol/L,干预后第24个月、第12个月、基线3个时间点上述指标比较,差异有统计学意义(F值分别为32.629、5.556、5.640、89.734、122.451、43.373、74.888、35.887;P<0.05)。第24个月时患者糖尿病自我管理行为量表中饮食(20.33±3.09)分、运动(11.13±1.54)分、血糖监测(11.78±1.99)分,足部护理(10.42±1.91)分,与基线和第12个月比较评分升高,差异有统计学意义(F值分别为25.276、72.250、74.503、37.928;P<0.01)。结论联合营养团队的程序化随访可以改善2型糖尿病患者肥胖、血糖、血脂相关指标,提高患者自我管理能力。

Application of programmatic follow-up of joint nutrition team in patients with type 2 diabetes mellitus

Objective To explore the effect of programmatic follow-up of joint nutrition team on the follow-up management of type 2 diabetes mellitus patients and to provide a basis for clinical practice.Methods Using the convenient sampling method,a total of 144 patients with type 2 diabetes mellitus who were treated at the Diabetes Specialist Follow-up Clinic of the First Affiliated Hospital of Xinjiang Medical University from March 2016 to December 2017 were selected,and the programmatic follow-up of joint nutrition team was used for prospective observation.After the completion of 2-year follow-up,the changes in obesity,blood glucose,blood lipids and self-care activities of patients at baseline,12th month and 24th month were compared using repeated measurements analysis of variance.Results In the end,141 patients completed the 2-year follow-up.Of the 141 patients,body mass index(BMI)was(21.73±1.89)kg/m2,waistline was(77.57±1.68)cm,waist-to-hip ratio was(0.87±0.04),fasting blood glucose was(5.14±0.92)mmol/L,glycosylated hemoglobin was(5.27±0.73)%,total cholesterol was(3.92±1.67)mmol/L,triglycerides was(1.94±0.68)mmol/L and low density lipoprotein was(1.04±0.31)mmol/L at the 24th month.The differences were statistically significant(F=32.629,5.556,5.640,89.734,122.451,43.373,74.888,35.887;P<0.05)among the 24th month,the 12th month and the baseline of the above indicators.At the 24 months,scores of diet,exercise,blood glucose monitoring and foot care in diabetic self-management behavior scale were respectively(20.33±3.09),(11.13±1.54),(11.78±1.99)and(10.42±1.91).Compared with baseline and the 12th month,scores increased,and the differences were statistically significant(F=25.276,72.250,74.503,37.928;P<0.01).Conclusions The programmatic follow-up of joint nutrition team can improve indexes related to obesity,blood glucose and blood lipids in patients with type 2 diabetes mellitus and improve self-management ability of patients.