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远程医疗在2型糖尿病管理中的应用

Telemedicine in the Management of Type 2 Diabetes Mellitus.

作者信息

Wang Guixia, Zhang Zhengyun, Feng Yakun, Sun Lin, Xiao Xianchao, Wang Gang, Gao Yuan, Wang Huan, Zhang Hong, Deng Yufeng, Sun Chenglin

机构信息

Department of Endocrinology, First Hospital of Jilin University, Changchun, China.

Department of Surgery, Shanghai Sixth People's Hospital, Shanghai JiaoTong University, Shanghai, China.

出版信息

Am J Med Sci. 2017 Jan;353(1):1-5. doi: 10.1016/j.amjms.2016.10.008. Epub 2016 Oct 27.

Abstract

OBJECTIVE

To explore a model of Internet-based integrated management of diabetes, we established a remote diabetes medical service platform (U-Healthcare) and evaluated its effectiveness and practicality.

MATERIALS AND METHODS

In total, 212 patients with type 2 diabetes mellitus were randomly assigned to 2 groups. Data from the intervention group were automatically transmitted through a glucometer; furthermore, this group received information regarding medicines, diet, exercise and other management through U-Healthcare. The control group received conventional medical treatment without any additional intervention. All patients were regularly followed up every 3 months for half a year.

RESULTS

At the 3-month follow-up, fasting plasma glucose levels of the intervention group were significantly lower than those at the baseline as well as those of the control group. Triglyceride levels of the intervention group were much lower than those at the baseline. At the 6-month follow-up, 2-hour postprandial plasma glucose levels of the intervention group significantly improved compared with those of the control group. HbA1c levels gradually decreased every 3 months in the intervention group, and the mean change in the levels was significantly greater in this group than in the control group (from 1.27-0.68%). At the end of the study, more than 80% of the patients in the intervention group adhered to blood glucose monitoring 2-3 days per week, and their compliance degree was 72%.

CONCLUSIONS

The Internet-based U-Healthcare system of integrated management in diabetes not only achieved better glycemic control, effectively improved HbA1c levels and decreased triglyceride levels but also enhanced patients' adherence to the medical team's instructions.

摘要

目的

为探索基于互联网的糖尿病综合管理模式,我们建立了一个远程糖尿病医疗服务平台(U-Healthcare)并评估其有效性和实用性。

材料与方法

总共212例2型糖尿病患者被随机分为2组。干预组的数据通过血糖仪自动传输;此外,该组通过U-Healthcare接收有关药物、饮食、运动及其他管理方面的信息。对照组接受常规医疗治疗,无任何额外干预。所有患者每3个月定期随访半年。

结果

在3个月的随访中,干预组的空腹血糖水平显著低于基线水平以及对照组。干预组的甘油三酯水平远低于基线水平。在6个月的随访中,干预组的餐后2小时血糖水平与对照组相比显著改善。干预组的糖化血红蛋白(HbA1c)水平每3个月逐渐下降,且该组水平的平均变化显著大于对照组(从1.27降至0.68%)。在研究结束时,干预组超过80%的患者每周坚持进行2 - 3天的血糖监测,其依从程度为72%。

结论

基于互联网的糖尿病综合管理U-Healthcare系统不仅实现了更好的血糖控制,有效改善了糖化血红蛋白水平并降低了甘油三酯水平,还提高了患者对医疗团队医嘱的依从性。

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