·糖尿病临床研究·

　　【摘要】 目的 探讨分阶段糖尿病达标管理(SDTM)模式对T2DM患者血糖的改善作用。 方法 分析2005～2010年进入江苏省省级机关医院糖尿病门诊SDTM管理的2581例T2DM患者基线状况。比较其中865例有6个月以上随访记录的患者，记录管理前后HbA1c和FBG的变化，并按不同HbA1c基线水平(<6.5%，6.5%～7.4%，7.5%～8.4%，8.5%～9.4%及≥9.5%)分组，比较血糖变化。同时按不同起始降糖药物治疗方案进行分组，分析治疗前后药物使用的变化。 结果 管理后HbA1c和FBG分别降至(6.75±1.20)%和(6.64±1.39)mmol/L(P<0.01)。HbA1c≥9.5%组(n=157)下降至(7.52±1.54)%，改善患者比例达88%。胰岛素使用比例升至34%(P<0.05)，且胰岛素组HbA1c下降幅度最大，约0.94%(P<0.01)。 结论 SDTM可有效改善T2DM患者HbA1c水平。

　　【关键词】 糖尿病，2型;管理;血糖;效果评估

Improving glycaemic control in T2DM patients: Implementation of staged diabetes targeting management OUYANG Xiao-jun, MO Yong-zhen, BIAN Rong-wen, et al. Center for Diabetes Care & Research, Jiangsu Geriatric Institute, Nanjing 210024, China

Corresponding author: BIAN Rong-wen, E-mail: ianrw@126.com

　　【Abstract】 Objective To assess the impact of the staged diabetes targeting management (SDTM) on glycaemic control of T2DM patients and analyze the influence of medication. Methods The 2581 T2DM patients were tracked from entry (baseline) into the program beginning in 2005 through 2010. Among them, 865 patients with a 6-month follow-up were compared for observing the changes of levels of HbA1c and FBG before and after management. They were divided into groups according to the baseline HbA1c (<6.5%, 6.5-7.4%, 7.5-8.4%, 8.5-9.4%, and ≥9.5%) for comparing the changes of blood glucose. At the same time, they were divided into groups according to the starting time of glucose-lowering medication for analyzing the changes of medication before and after treatment. Results With medication, the levels of HbA1c and FBG decreased to 6.75±1.20% and 6.64±1.39mmol/L respectively (P<0. 01). In the ≥9.5% group (n=157), the level of HbA1c was decreased to 7.52±1.54%, the improvement rate was 88%. The use of insulin was increased to 34% (P<0.05), and the decrease amplitude of HbA1c level of the insulin group was the biggest, about 0.94% (P<0.01).

　　Conclusion SDTM improves glycaemic control significantly.

　　【Keywords】Diabetes mellitus, type 2; Management; Blood glucose; Outcome assessment