互联网+移动医疗模式下服用恩格列净2型糖尿病患者管理

Management of type 2 diabetes patients taking Empagliflozinin:a mode of internet+mobile medicine

摘要:

目的 探讨在互联网移动医疗管理下应用钠-葡萄糖协同转运蛋白2 抑制剂(SGLT-2i)恩格列净治疗2型糖尿病的疗效。方法 选择中国人民解放军总医院第一医学中心内分泌科2017年1月至2019年12月门诊收治的2型糖尿病患者97例,在原降糖方案基础上加用恩格列净。随机分为照护组及对照组,照护组49例采用互联网移动医疗管理,对照组48例采用门诊常规糖尿病管理。干预 6个月后,分别比较2组临床相关指标、自我管理能力(包括饮食控制、遵医用药、监测血糖及戒烟合格率)及焦虑自评量表(SAS)评分。采用SPSS 16.0软件进行数据分析。根据数据类型,组间比较分别采用t检验及χ²检验。 结果 经过管理后,照护组及对照组体质量指数[(24.2±2.7) 和 (25.7±2.5)kg/m²]、血糖 [空腹血糖:(6.2±0.3) 和 (7.9±0.4) mmol/L; 餐后2 h血糖:(9.5±0.5) 和 (10.7±0.7)mmol/L; 糖化血红蛋白:(7.0±0.3) 和 (7.9±0.7)%]、甘油三酯[(1.41±0.57) 和 (2.09±0.62)mmol/L]、尿白蛋白/肌酐 [(14.4±8.4) 和 (19.3±10.5) mg/mmol]比较,差异均有统计学意义(均P<0.05)。照护组患者饮食控制、遵医用药、监测血糖及戒烟合格率均高于对照组[38(77.6%)和12(25%),47(95.9%)和36(75%),44(89.8%)和31(64.6%),39(79.6%)和29(60.4%)],差异均有统计学意义 (均P＜0.05)。2组SAS评分比较,差异有统计学意义(P<0.05)。结论 互联网移动医疗有可能改善口服恩格列净的2型糖尿病患者的临床指标,降低SAS评分,提高患者自我管理能力,比较适合于慢性病的长期管理。

Abstract:

Objective To investigate the efficacy of sodium-dependent glucose transporters 2 inhibitor (SGLT-2i) Empagliflozin in the treatment of type 2 diabetes mellitus (T2DM)in a management mode of the internet plus mobile medicine. Methods From January 2017 to December 2019, a total of 97 T2DM patients with poorly controlled blood glucose in the Outpatient of Endocrinology Department of Chinese PLA General Hospital were randomly divided into the care group (n = 49) and the control group (n = 48). The patients were treated with Empagliflozin in addition to the basic hypoglycemic regimen. The care group were managed in a mode of the internet plus mobile medicine, and the control group in the routine outpatient clinics. After 6 months, the two groups were compared in the clinical indexes, self-management abilities featuring diet control, medication compliance, blood glucose monitoring and smoking cessation qualified rate, and the scores of self-rating anxiety scale (SAS). SPSS statistics 16.0 was used for statistical analysis. Data comparison between two groups was performed using t test or χ² test depending on data type. Results After management, the care group and control group differed in fasting blood glucose [ (6.2±0.3) vs (7.9±0.4) mmol/L], 2 h postprandial blood glucose [(9.5±0.5) vs (10.7±0.7) mmol/L], hemoglobin A1c [(7.0±0.3) vs (7.9±0.7)%], triglyceride [(1.41±0.57) vs (2.09±0.62) mmol/L], urine albumin/creatinine [(14.4±8.4) vs (19.3±10.5) mg/mmol], and body mass index [(24.2±2.7) vs (25.7±2.5) kg/m²] (P<0.05 for all). The care group had higher qualified rates of diet control [38(77.6%) vs 12(25%)], medication compliance [47(95.9%) vs 36(75%)], blood glucose monitoring [44(89.8%) vs 31(64.6%)], and smoking cessation [39(79.6%) vs 29(60.4%)] than the control group, and the differences were statistically significant (P<0.05). The SAS scores between two groups was statistically significant(P<0.05). Conclusion The mode of internet plus mobile medicine can improve the clinical indicators of T2DM patients who take orally Empagliflozin, reduce anxiety scores, and enhance the patient′s self-management. It is suitable for long-term management of chronic diseases.