微信教育在2型糖尿病患者管理中的应用

Health education by Wechat in management of patients with type 2 diabetes

摘要:

目的 探讨微信教育模式对2型糖尿病(T2DM)患者管理的有效性。方法 入选2017年12月至2018年10月上海交通大学附属第六人民医院内分泌代谢科门诊新诊断T2DM患者59例,随机数表法分为对照组29例和研究组30例。对照组服用二甲双胍片,500mg/次,2次/d,随餐服用。研究组服药同时通过微信监督和管理,持续推送糖尿病知识3个月。比较2组患者干预前及干预3个月后人体测量学参数及生化指标。采用SPSS 17.0统计软件对数据进行分析。依据数据类型采用t检验或Fisher精确检验进行组间比较。结果 相比治疗前,治疗3个月后2组患者体质量指数、空腹血糖和糖化血红蛋白水平降低,研究组总胆固醇[(4.7±1.1)和(5.1±1.4)mmol/L]、甘油三酯[(2.2±1.5)和(2.8±1.9)mmol/L]]和低密度脂蛋白胆固醇水平降低[(2.7±0.7)和(3.0±0.9)mmol/L],差异均具有统计学意义(P＜0.05)。治疗3个月后研究组相比对照组糖化血红蛋白水平下降幅度大[(-1.6±0.8)% 和(-1.1±1.0)%；P=0.026],血糖达标率高[86.7%(26/30)和62.1%(18/29)；P=0.03]。结论 通过微信可对新诊断T2DM患者进行有效管理。

Abstract:

Objective To explore the effectiveness of health education model using Wechat (Wechat education model) in the management of type 2 diabetes mellitus (T2DM). Methods From December 2017 to October 2018,59 newly diagnosed T2DM patients were selected from our outpatient department of endocrine metabolism department. They were randomly divided into control group (n=29) and study group (n=30). The control group took metformin tablets, 500 mg once, twice daily. In the study group, besides same medication regimen, diabetes knowledge was continuously promoted for 3 months through Wechat supervision and management. The anthropometric parameters and biochemical indices of the 2 groups were compared before and 3 months after the intervention. SPSS statistics 17.0 was used for data analysis. According to the data type, Student′s t test or Fisher′s exact test were used for intergroup comparison. Results Compared with the values before treatment, their body mass index, fasting blood glucose and glycosylated hemoglobin levels were decreased in the both groups after 3 months of treatment. In the study group, the levels of total cholesterol [(5.1±1.4) vs (4.7±1.1)mmol/L] , triglycerides [(2.8±1.9) vs (2.2±1.5)mmol/L] and low density lipoprotein cholesterol [(3.0±0.9) vs (2.7±0.7)mmol/L] were significantly decreased after treatment (P<0.05). The study group achieved more obviously decrease in glycosylated hemoglobin [(-1.6±0.8)% vs (-1.1±1.0)%, P=0.026], and higher ratio of the patients reaching blood glucose standard [86.7%(26/30) vs 62.1%(18/29), P=0.03] when compared with the control group. Conclusion Wechat can effectively manage the newly diagnosed T2DM patients.