Beijing Key Laboratory of Diabetes Mellitus Prevention and Research, Department of Endocrinology, Beijing Luhe Hospital, Capital Medical University, 113 Xinhua South Road, Tongzhou District, Beijing City, 101100, China.
Acta Diabetol. 2020 Sep;57(9):1049-1056. doi: 10.1007/s00592-020-01518-4. Epub 2020 Apr 4.
The past 3 decades witnessed the rapid growth of diabetes in China. To better serve large numbers of patients, the Chinese Medical Doctor Association launched metabolic management center (MMC) program which is featured with a one-stop and comprehensive diabetes management mode in 2016. It is worth exploring whether MMC model is better than conventional models in management.
In this study, 228 patients with type 2 diabetes were recruited, and 193 patients completed the study. Therapeutic effects and health care costs were analyzed.
Our results showed that decreases in HbA and TG/HDL-C values were significantly greater in the MMC group than in the control group. The increase in HDL-C was significantly higher in the MMC group than in the control group. The percentage of patients whose HbA lower than 7% was significantly higher in the MMC group. The results of the UKPDS model simulation showed that within 30 years, with the slight increases in treatment costs, the average life expectancy and total QALE of the MMC group are higher than those of the control group by 0.61 and 0.51 year, respectively. Further study showed that the drug intervention in the MMC group was significantly stronger. In addition, the questionnaires revealed that MMC group performed better in diabetes knowledge tests and have higher patient satisfaction rates of medical services. More patients in the MMC group adopted a more favorable diet strategy. These advantages enable MMC to achieve more short-term and long-term benefits in diabetes treatment than conventional mode.
过去 30 年来,中国的糖尿病患者人数迅速增长。为了更好地服务大量患者,中国医师协会于 2016 年推出了代谢管理中心(MMC)项目,其特点是采用一站式、综合的糖尿病管理模式。值得探索的是,MMC 模式在管理方面是否优于传统模式。
本研究纳入了 228 例 2 型糖尿病患者,其中 193 例完成了研究。分析了治疗效果和医疗保健费用。
结果显示,与对照组相比,MMC 组的 HbA1c 和 TG/HDL-C 值降低更为显著,HDL-C 升高更为显著,HbA1c 低于 7%的患者比例显著更高。UKPDS 模型模拟结果显示,在 30 年内,随着治疗费用的轻微增加,MMC 组的平均预期寿命和总 QALE 分别比对照组高 0.61 年和 0.51 年。进一步的研究表明,MMC 组的药物干预更为显著。此外,问卷调查显示,MMC 组在糖尿病知识测试中表现更好,对医疗服务的满意度更高。更多的 MMC 组患者采用了更有利的饮食策略。这些优势使 MMC 在糖尿病治疗中获得了比传统模式更短期和长期的益处。