Department of Endocrinology and Metabolism, Yan'an University Affiliated Hospital, Yan'an, Shaanxi, China.
Medicine (Baltimore). 2022 Nov 11;101(45):e31342. doi: 10.1097/MD.0000000000031342.
The Chinese Medical Doctor Association has initiated metabolic management center (MMC) program for 6 years since 2016 nationwide. It is worth investigating the level of control metabolic outcomes in patients with type2 diabetes (T2DM) after MMC model in Yan'an, northwest China. Patients with T2DM was admitted to MMC in Yan'an University Affiliated Hospital from November 2018 to July 2021. They were asked to revisit hospital every 3 months. Blood glucose, blood pressure and blood lipids at baseline were compared to its counterparts after 1 year MMC management. Glycosylated hemoglobin and low density lipoprotein cholesterol (LDL-C) level in T2DM patients after 1 year management were lower than their baseline level (glycosylated hemoglobin 7.74 ± 1.94% vs 8.63 ± 2.26%, P < .001; LDL-C 1.81 ± 0.73mmol/L vs 2.18 ± 1.49mmol/L, P < .001). Mean HOMA-β increased after management (65.89 ± 90.81% vs 128.38 ± 293.93%, P < .05). After 1 year of management, patients in high school or above group achieved higher control rate of body mass index than those in middle school or below group (71.82% vs 28.18%, P = .043). high density lipoprotein cholesterol control rate was higher in high income group (42.86% vs 34.97%, 16.28%, P = .012), while LDL-C control rate was higher in low-income group (97.67% vs 78.57%, 84.51%, P = .018). fasting plasma glucose control rate in new diagnosis group was higher than that of the middle and long course groups (71.43% vs 52.38%, 42.44%, P = .002). The comprehensive control rate increased from 9.83% at baseline to 26.15% after 1 year MMC management. The metabolic outcomes and their control rate in T2DM patients were improved after 1 year MMC management. It indicated that patients may achieve more benefits with MMC management.
中国医师协会自 2016 年起在全国范围内启动了代谢管理中心（MMC）项目，已持续 6 年。在中国西北部的延安，我们有必要研究 MMC 模式对 2 型糖尿病（T2DM）患者代谢控制结局的影响。2018 年 11 月至 2021 年 7 月，延安大学附属医院的 MMC 收治 T2DM 患者，要求每 3 个月复诊一次。比较患者 MMC 管理前 1 年的血糖、血压和血脂，与基线相比，T2DM 患者的糖化血红蛋白（HbA1c）和低密度脂蛋白胆固醇（LDL-C）水平在 MMC 管理 1 年后均降低（HbA1c 7.74±1.94%比 8.63±2.26%，P<0.001；LDL-C 1.81±0.73mmol/L 比 2.18±1.49mmol/L，P<0.001）。管理后平均 HOMA-β增加（65.89±90.81%比 128.38±293.93%，P<0.05）。管理 1 年后，高中及以上学历组患者的体质指数控制率高于中学及以下学历组（71.82%比 28.18%，P=0.043）。高收入组高密度脂蛋白胆固醇控制率较高（42.86%比 34.97%、16.28%，P=0.012），而低收入组 LDL-C 控制率较高（97.67%比 78.57%、84.51%，P=0.018）。初诊组空腹血糖控制率高于中长程组（71.43%比 52.38%、42.44%，P=0.002）。MMC 管理 1 年后，综合控制率从基线时的 9.83%上升至 26.15%。MMC 管理 1 年后，T2DM 患者的代谢控制率得到改善，表明患者可能通过 MMC 管理获得更多获益。
