Research On The Self-health Management Of High Risk Diabetic Population Based On The Health Risk Assessment

Objectives:To understand the differences between the demographic variability of blood glucose, blood lipid and demographic characteristics of the people consulting in a physical examination center in certain tertiary hospital, and to understand the diabetic risk factors among people in the physical examination as well as the general rule of prevalence rates of diabetes and pre-diabetes, and to study the effects of diabetic health risk assessment and intervention on the health management of pre-diabetic population, and discuss the pre-diabetic health management pattern on the basis of health risk assessment and intervention, with an aim to supply health management with a foundation for those who are in the diabetes high risk population Methods: From August in 2014 to October in 2015,the population that had physical examination in the top three hospital in Xinjiang was conducted, and the 274 cases of diabetes and pre-diabetes patients diagnosed through blood glucose test with no obvious diabetic symptoms were chosen as the objects of study. Methods: Input the random serial number of 274 cases of objects of study that met the inclusion and exclusion criteria and were randomly divided into the control group(137 cases) and experiment group(137 cases) into the computer. Both the two groups signed informed consent and received questionnaire survey about their life style, motion state, family history, and martial and reproductive history. The above-mentioned information, together with body mass index, blood pressure, blood lipid and blood glucose, became the baseline information of the objects of study. The experiment group received 6-month one-to-one comprehensive intervention management. The content of comprehensive intervention included exercise intervention, diet intervention, psychological intervention, behavioral intervention, weight, tobacco and alcohol intervention, regular recheck, and health education. While the control group received 6-month conventional intervention management, including regular recheck and health education. The patients in two groups received monthly recheck, together with health education, and waistline, physical activities, tobacco and liquor, diet, blood lipid, fasting blood glucose measurement and diabetic risk assessment in the 1st, 3rd, and 6th month, so as to observe the effects of different intervention measures. Results: 1) After the health management intervention, 6 cases of test group samples were prolapse, the dropout rate was 4.4%, and 10 cases of the comparative group were also prolapse, the dropout rate was 7.3%. According to the design requirements, the sample size in each group requires at least 114 people, and that two groups were in line with the minimum sample size requirement. 2)The method of sensitivity evaluation for Chinese adults at risk for diabetes had high specificity: 632 cases of blood glucose level was measured in 1081 cases of healthy people were normal, 449 cases of abnormal blood sugar levels, the use of adult diabetes risk assessment in China to evaluate the risk of the two groups, the results of 449 cases of abnormal blood glucose were detected in 373 cases of high risk; and among the 632 cases of normal blood glucose,543 cases of that were low risk, sensitivity of the health risk assessment method was 83.1%, the specificity was 85.9%.3) overall health level in healthy crowd low,among 1081 cases of healthy physical examination population, 62 cases of diabetes patients, 387 cases of diabetes, the prevalence of the two were 5.7% and 35.8%, that is the physical examination population of blood glucose abnormalities accounted for 41.5%,the physical conditions of the physical examination population were poor. Of the 1081 cases of physical examination population, there were 462 cases were diagnosed as diabetic high risk group through diabetic health risk assessment, accounting for 42.7% of the physical examination population,and 62 cases diagnosed as diabetic population through blood glucose detection, and 387 cases of pre-diabetic population, accounting for 13.4% and 83.8% of the diabetic high risk population respectively. 4). There were improvements of various degrees of the control rates of some measurement index, biochemical index and life style in the intervention group after 3-month comprehensive health intervention management than before(p<0.05), and the difference was of statistical significance. Measurement index, such as weight, BMI, waistline in the control group showed improvements when compared with those before intervention(p<0.05), and the difference was of statistical significance. Although the mean values of blood lipid and blood glucose decreased, the intervention effect was not obvious(p>0.05), with no statistical significance. Multiple measurement index, biochemical index and intervention index in both experiment group and control group showed remarkable improvements(p<0.05) than those before intervention after 6-month management, and the difference was of statistical significance. When compared with the control group, the experiment group showed better intervention effects(p<0.05), with statistical significance. 5). After 6-month intervention in the two groups, a second risk assessment, together with the risk grade variation of the objects of study was conducted(Chi-square=, p<0.05), and the difference was of statistical significance. Conclusion: The health situation of individuals tested their blood glucose, blood lipidis are not that optimistic, but it can be improved by changing the diet behavior. The method of adult-diabetes health risk assessment in our country has high specificity and sensitivity, which can be used to health risk assessment of health physical examination personnel in high-risk diabetes healthy population screening and preliminary determination in diabetes risk, there are several factors of high-risk individuals. This study using the method of diabetes risk assessment of healthy people, and the people in high risk patients with diabetes were targeted health interventions,according to the comprehensive management of different risk factors, a number of physiological test group health intervention management, biochemical indexes and blood glucose, blood lipid were different in terms of the degree of improvement. With the improvement of people’s living standard, increasing number of people begin to join the team for the healthy body examination. Seized the large populations of diabetes health management can be considered by health risk assessment, the high-risk population of different risk factors for targeted health interventions in order to improve health management,the work efficiency and the management of the health status as well as the health promotion ability.