Di Bonito Procolo, De Natale Claudia, Salvatore Teresa, Vaccaro Olga, Armentano Vincenzo, Adinolfi Domenico, Giugliano Roberto, Capaldo Brunella
Dipartimento di Medicina Interna, Ospedale S. Maria delle Grazie, Naples, Italy.
Ann Ist Super Sanita. 2009;45(2):162-7.
To improve the quality of diabetes care, a project of integrated diabetes management (PIDM) involving some general practitioner (GPs) has been recently undertaken. The purpose of this study is to compare features and treatment of patients followed by diabetic outpatient clinics (DOCs) with those cared for by GPs trained to the PIDM. Twenty-one DOCs and eleven GPs participated in the study. Patients followed by DOCs (n. = 1110) showed longer duration of diabetes, higher prevalence of metabolic syndrome than patients followed by GPs (n. = 305). More patients followed in DOCs performed insulin therapy, while a lower number received ACE /angiotensin blockers, antiplatelet, lipid lowering drugs and multifactorial intervention than patients followed by GPs. The proportion of patients in good control for glucose, pressure and lipid levels was similar in the two groups. Conversely, a higher number of patients attending DOCs were in poor glycemic, pressure, and lipid control compared with patients followed by GPs. In conclusions, PIDM provides satisfactory results in terms of overall glucose, pressure and lipid control, thus encouraging implementation of PIDM to meet the increasing demand for diabetes care.
为提高糖尿病护理质量,最近开展了一项涉及一些全科医生(GP)的综合糖尿病管理(PIDM)项目。本研究的目的是比较糖尿病门诊(DOC)随访患者与接受PIDM培训的全科医生护理患者的特征和治疗情况。21个DOC和11名全科医生参与了该研究。与全科医生随访的患者(n = 305)相比,DOC随访的患者(n = 1110)糖尿病病程更长,代谢综合征患病率更高。更多在DOC随访的患者接受胰岛素治疗,而与全科医生随访的患者相比,接受ACE/血管紧张素阻滞剂、抗血小板、降脂药物和多因素干预的患者数量较少。两组中血糖、血压和血脂水平控制良好的患者比例相似。相反,与全科医生随访的患者相比,在DOC就诊的患者血糖、血压和血脂控制不佳的人数更多。总之,PIDM在总体血糖、血压和血脂控制方面提供了令人满意的结果,因此鼓励实施PIDM以满足对糖尿病护理日益增长的需求。