目的 探讨手机微信管理模式对初发老年2型糖尿病患者健康管理的效果.方法 选取2014年1—2月在江西省人民医院内分泌科门诊就诊筛查出的老年初发2型糖尿病患者80例,根据随机数字表法分为试验组和对照组,每组40例.对照组采用门诊常规管理模式,试验组采用手机微信管理模式,均干预6个月.比较两组入组及干预后3、6个月时躯体健康监测指标和糖化血红蛋白(HbA 1c)、血压、低密度脂蛋白胆固醇(LDL-C)达标率及低血糖发生率、糖尿病控制状况.结果 两组性别、年龄、文化程度、婚姻状况及高血压、高脂血症发生率间差异均无统计学意义(P>0.05).两组空腹血糖(FPG)、HbA 1c、BMI间差异无统计学意义(P>0.05),不同时间点FPG、HbA 1c、BMI间差异有统计学意义(P<0.05),干预方法和时间在FPG、HbA 1c、BMI上存在交互作用(P<0.05);两组餐后2 h血糖(2 hPG)、收缩压、舒张压、总胆固醇(TC)、三酰甘油(TG)、LDL-C间差异有统计学意义(P<0.05),不同时间点2 hPG、收缩压、舒张压、TC、TG、LDL-C间差异有统计学意义(P<0.05),干预方法和时间在2 hPG、收缩压、舒张压、TC、TG、LDL-C上存在交互作用(P<0.05).两组干预前低血糖发生率均为0,两组干预前HbA 1c、血压、LDL-C达标率间差异无统计学意义(P>0.05);两组干预后3个月HbA 1c、血压达标率及低血糖发生率间差异无统计学意义(P>0.05),而LDL-C达标率间差异有统计学意义(P<0.05);两组干预后6个月HbA 1c、LDL-C达标率间差异有统计学意义(P<0.05),而血压达标率及低血糖发生率间差异无统计学意义(P>0.05).两组糖尿病及并发症自觉症状得分间差异无统计学意义(P>0.05),不同时间点糖尿病及并发症自觉症状得分间差异有统计学意义(P<0.05),干预方法和时间在糖尿病及并发症自觉症状得分上存在交互作用(P<0.05);两组生活习惯、治疗情况、生存技能、治疗目标、知识结构得分间差异有统计学意义(P<0.05),不同时间点生活习惯、治疗情况、生存技能、治疗目标、知识结构得分间差异有统计学意义(P<0.05),干预方法和时间在生活习惯、治疗情况、生存技能、治疗目标、知识结构得分上存在交互作用(P<0.05).结论 手机微信管理模式对初发老年2型糖尿病患者健康管理效果较好,值得推广.%Objective To discuss effect of WeChat management mode on the health management of elderly patients with newly diagnosed type 2 diabetes. Methods Eighty elderly patients with newly diagnosed type 2 diabetes after screening in Endocrinology Outpatient of Jiangxi Provincial People′s Hospital from January to February 2014 were selected and divided into experiment group and control group by random number table method (n = 40). The patients in the control group received routine management mode and the patients in the experiment group received WeChat management mode. All were intervened for 6 months. The monitoring indicators of physical health,the control rate of glycosylated hemoglobin (HbA 1c ),blood pressure and low density lipoprotein cholesterol (LDL - C)and incidence of hypoglycemia,and the control status of diabetes at the time of enrollment and 3 months,6 months after intervention were compared. Results There were no significant differences in gender, age,educational level,marital status,incidence of hypertension and hyperlipidemia between the two groups (P > 0. 05). There was no significant difference in fasting plasma glucose (FPG),HbA 1c and BMI between the two groups (P > 0. 05),there were significant differences in FPG,HbA 1c and BMI at different time points (P < 0. 05),methods and time of intervention had interactive effects on FPG,HbA 1c and BMI (P < 0. 05). There were significant differences in plasma glucose postprandial 2 hours (2 hPG),systolic blood pressure,diastolic blood pressure,total cholesterol (TC),triglyceride (TG)and LDL - C between the two groups (P < 0. 05). There was significant difference in 2 hPG,systolic blood pressure,diastolic blood pressure,TC,TG and LDL - C at different time points (P < 0. 05). The methods and time of intervention had interactive effects on 2 hPG,systolic blood pressure,diastolic blood pressure,TC,TG and LDL - C (P < 0. 05). The incidence of hypoglycemia in both groups was 0 before intervention. There was no significant difference in the control rate of HbA1c ,blood pressure, LDL - C between the two groups before intervention (P > 0. 05). There was no significant difference in HbA 1c ,control rate of blood pressure and incidence of hypoglycemia between the two groups 3 months after intervention (P > 0. 05),while there was significant difference in LDL - C (P < 0. 05). The control rate of HbA 1c and LDL - C between the two groups 6 months after intervention was significantly different (P < 0. 05),while the control rate of blood pressure and incidence of hypoglycemia were not significantly different (P > 0. 05). There was no significant difference in scores of subjective symptoms of diabetes and complications between the two groups (P > 0. 05),there were significant differences in scores of subjective symptoms of diabetes and complications at different time points (P < 0. 05),methods and time of intervention had interactive effects on the scores of subjective symptoms of diabetes and complications (P < 0. 05). There were significant differences in the scores of living habits, treatment status,survival skills,treatment goals and knowledge structure between the two groups (P < 0. 05),and the scores of living habits,treatment status,survival skills,treatment goals and knowledge structure were significantly different at different time points (P < 0. 05),and methods and time of intervention had interactive effects on the scores of living habits,treatment status,survival skills,treatment goals and knowledge structure (P < 0. 05). Conclusion WeChat management mode has good effects on the health management of elderly patients with newly diagnosed type 2 diabetes,which is worth popularizing.
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