| Objective:To compare the changes of metabolic indexes such as blood glucose,blood lipid and blood pressure of elderly patients with type 2 diabetes after 1 year management with three different models in a community of Taiyuan City,so as to provide a theoretical basis for exploring a scientific,effective and widely popularized management mode.Methods:According to the inclusion and exclusion criteria,240 elderly patients with diabetes who had been filed from December 2020 to December 2021 in a community in Taiyuan were randomly selected as research objects.According to the management mode,they were randomly divided into community traditional group,community strengthening group and community team reinforcement group for 12 months of management,and each group has eighty people.Baseline survey of patients in the three groups include age,gender,disease course,waist circumference,body mass index,fasting blood glucose,blood lipid and blood pressure,etc.Fasting blood glucose and systolic and diastolic blood pressure were measured at sixty month,and fasting blood glucose,triglyceride,total cholesterol,low density lipoprotein and systolic and diastolic blood pressure were measured at twelfth months.Excel and SPSS26.0 statistical software were used for data collation and analysis.Measurement data is expressed by mean ±standard deviation,and counting data is expressed in frequency and percentage.Repetitive measure analysis of variance,paired t test,analysis of variance and chi-square test were used to analyze between groups and within groups.Through the above analysis,we can compare the differences of fasting blood glucose,blood lipid,blood pressure and other metabolic indexes between and within groups to evaluate the effects of three different management modes.Results:1.In this study,240 elderly community patients with diabetes were included.The baseline levels of the three groups included age,sex,body mass index,course of disease,waist circumference,fasting blood glucose,blood lipid and blood pressure,and there were no statistical differences between the groups(P > 0.05),indicating that the study had a certain comparability.2.After 6 months,there was no statistically significant difference in fasting blood glucose(FPG),systolic blood pressure(SBP),and diastolic blood pressure(DBP)among the three groups of patients(P>0.05);Compared to baseline,there were no significant changes in FPG,SBP,and DBP in the community traditional group patients(P>0.05);In the community strengthening group,only FPG significantly decreased(P<0.05);In the community team reinforcement group,only FPG and SBP significantly decreased(P<0.05).3.After 12 months,compared with the community traditional group and the community strengthening group,the FPG,total cholesterol(TC),SBP,and low-density lipoprotein cholesterol(LDL-C)of patients in the community team reinforcement group were significantly reduced(all P<0.05);Compared with the community traditional group,the TG of patients in the community team reinforcement group was significantly reduced(P<0.05),but there was no significant difference in TG between the community team reinforcement group and the community strengthening group(P>0.05).Compared to the baseline,the FPG、 TG、TC、 LDL-C and SBP of the three groups of patients were all better than the baseline level.However,there was no significant difference in DBP between and within the three groups of patients(P>0.05).4.Overall,the community team reinforcement group experienced the largest decrease and achieved the best results,followed by the community strengthening group,which still needs improvement.Research shows that the establishment of a diabetes management team with specialized knowledge in the community and the standardized and professional health management of diabetes patients have significantly benefited the elderly diabetes patients.Conclusion:1.After 6 months of community management,intergroup changes in blood glucose and blood pressure of the three groups were not significant statistically,especially before and after the community traditional management group was not good.Therefore,from the short term management data,the management of blood glucose and blood pressure in elderly diabetic patients has not seen obvious ideal effect.2.With the extension of management time,after 12 months of community management,the FPG、TG、TC、LDL-C and SBP of the three groups of patients showed significant improvement compared to previous management.However,the DBP is difficult to reach the standard.In the future research,special attention should be paid to the management of elderly diabetes patients in DBP.3.Overall,the community team reinforcement group is superior to the community strengthening group and the community traditional group.Therefore,the health management ability of community health service centers can be improved to a certain extent by selecting endocrinology experts to sink communities,strengthening the construction of community diabetes team and enhancing the overall medical level of community team,which can provide reference for optimizing community management mode. |
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