关键词:

1型糖尿病, 整合医疗管理, 胰岛素强化治疗, 酮症, 管理效果

Abstract:

Objective To analyze the effect of integrated medical management on patients with type 1 diabetes mellitus（T1DM）. Methods A total of287 T1DM patients were enrolled in this study，and integrated medical management was implemented for them for three years. Through special government funds，a treatment center was established to provide patients with therapeutic intervention and standardized chronic disease management in the outpatient department. Interventions included insulin therapy，injection needles，blood glucose self ⁃ monitoring （SMBG）devices，regular diabetes education，and observation indicator monitoring.The management effect was evaluated by comparing the observation indicators before and after the management for three years. Results SMBG frequency and intensive insulin therapy rate of T1DM patients in children and adolescents，adults and the elderly increased after the management（all P < 0.01），but the ketosis incidence and hospitalization frequency decreased （all P < 0.05），and daily insulin dose of T1DM patients in children and adolescents increased（P < 0.01）. Compared with those before the management，the 2 h postprandial c ⁃ peptide level，HbA1c compliance rate and exercise compliance rate of T1DM patients in children and adolescents and adults decreased（all P < 0.05），and dietary control rate of adult T1DM patients increased（P < 0.01）. Conclusion Integrated medical management is effective for improving self ⁃management awareness and skills of T1DM patients，reducing the occurrence of complications and medical cost. However，it is still necessary for patients to have exercise and diet control to strengthen the management effect.

Key words:

type 1 diabetes mellitus, integrated medical management mode, intensive insulin therapy, ketosis, management effect