| Objective:1.To study the changes of fasting blood glucose,blood pressure,blood lipids,BMI,dietary structure,exercise,smoking,alcohol consumption,medication and other changes of patients with diabetic mellitus type 2 after the comprehensive management of chronic diseases in the community and whether there are differences in the changes of different age groups.2.To study the changes of fasting blood glucose,blood pressure,blood lipids,BMI,dietary structure,exercise,smoking,alcohol consumption,medication and so on in patients with diabetes mellitus type 2 after comprehensive management of chronic diseases in the community,and analyze them by age.3.Analyze the correlation between the change of fasting blood glucose and the control of blood pressure,blood lipids and BMI.According to the research results,it provides suggestions for the comprehensive management of chronic diseases of diabetes mellitus.Method:From 4325 patients with diabetes mellitus type 2 who were registered in Puyang Community in Changchun,300 patients who were continuously included in the comprehensive management of chronic diseases in the community in 2019 and 2020 and participated in the annual physical examination were randomly selected as the research objects.The self-control research method is adopted before and after the comprehensive management of chronic diseases,and the intervention time is one year.The comprehensive management methods of community chronic diseases include: 4 diabetes mellitus health education lectures every year(focusing on blood glucose monitoring,diabetes mellitus diet,scientific exercise,the harm of diabetes mellitus,the symptoms and treatment methods of hypoglycemia,smoking cessation,alcohol restriction,etc.);In the community chronic disease clinic,general practitioners provide medication guidance for patients,issue individualized health education prescriptions,and guide patients to eat reasonably and exercise healthily;Family doctors conduct face-to-face or telephone health follow-up once a quarter,and test blood glucose free of charge;The contents of the physical examination refer to the contents of residents’ physical examination in the third edition of the national basic public health service specifications.The family doctor filled in the residents’ physical examination form and timely fed back the results to the patients.Collect the health examination data of residents in 2019 and 2020,and conduct self-control analysis.According to whether fasting blood glucose decreased,they were divided into fasting blood glucose improved group and fasting blood glucose not improved group.Stratified by age,they are divided into: the first group:(35-44)years old,the second group:(45-54)years old,the third group:(55-64)years old(each group includes upper and lower limits),and the fourth group:(65 years old and above).The relevant data of this study were analyzed by statistical software SPSS25.0.The quantitative variables were expressed by means of mean and standard deviation.The paired t-test or two independent sample t-test was used for the comparison between the sample groups that conform to the normal distribution,and the rank sum test was used for the samples that do not conform to the normal distribution.Qualitative variables were expressed by rate or percentage,and chi square test was used for comparison between groups.The inspection level is set as: α= 0.05,P< α the original hypothesis was rejected,and the difference was statistically significant.Compare the changes of blood pressure,fasting blood glucose,blood lipids,BMI,medication,diet structure,exercise time,exercise mode,smoking,drinking and other changes before and after the intervention,and whether there are differences in different age groups;The correlation between the changes of fasting blood glucose and the control of blood pressure,blood lipids and BMI provides suggestions for the comprehensive management of chronic diseases of diabetes mellitus.Results:(1)There was significant difference in total cholesterol level and systolic blood pressure level after comprehensive management of chronic diseases in the community(p<0.05).Total cholesterol level decreased and systolic blood pressure level increased.There was no significant difference in fasting blood glucose level,dietary structure,hypoglycemic regimen,and fasting blood glucose changes among different hypoglycemic regimens.(2)After the comprehensive management of chronic diseases mellitus in the community,there were significant differences in the time of exercise and the way of the use of antihypertensive drugs(p<0.05).The time of exercise was longer than before,the number of patients who did not take antihypertensive drugs and single drug treatment decreased,and the number of patients who took combined drugs increased.(3)Stratified by age:(55～64 years old)there was a difference between the time of exercise and the time of persistent exercise in the age group,and the time of exercise was longer than before(p<0.05).There was significant difference in systolic blood pressure in the age group(65～74 years old),and the systolic blood pressure was higher than that before(p<0.05).(4)Compared with the non improved fasting blood glucose group,the fasting blood glucose improved group had statistically significant differences in triglycerides,cholesterol and the time of each exercise(minutes)(p<0.05),triglycerides and cholesterol decreased compared with the previous group,and the time of each exercise prolonged;The systolic blood pressure in the group without improvement of fasting blood glucose was different,higher than that before,and there was no significant difference in other indicators.Conclusion:(1)The comprehensive management of chronic diseases in the community plays a significant role in reducing the cholesterol level of patients with diabetes mellitus,improving their lifestyle,and adjusting the medication plan,which is worthy of promotion.(2)The management of fasting blood glucose in community patients with diabetes mellitus type 2 should pay attention to the comprehensive management of blood pressure,blood lipids and lifestyle,especially the management of systolic blood pressure,triglyceride,total cholesterol and the length of exercise.(3)We should pay more attention to the community comprehensive management of patients with diabetes mellitus type 2 on the rationality of the treatment plan,and formulate and adjust the treatment plan of reducing blood pressure and glucose reasonably according to the drug action mechanism and principle. |
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