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在糖尿病患者中实施本地化健康促进模式:一项现场试验。

Implementing a localized health promotion model in diabetic patients: a field trial.

作者信息

Tarjoman Termeh, Mohammadi Mahmonir, Mousavi Fatemeh, Chouhdari Arezoo, Nikpajouh Akbar, Alimohammadzadeh Khalil, Shojaei Parisa, Shafiee Akbar

机构信息

Social Determinants of Health Research Center, Amir-al-Momenin Hospital, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

Department of Cardiology, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Tehran, Iran.

出版信息

J Diabetes Metab Disord. 2025 May 9;24(1):117. doi: 10.1007/s40200-025-01624-6. eCollection 2025 Jun.

Abstract

OBJECTIVES

Diabetes mellitus, a major cardiovascular risk factor, is a leading non-communicable disease globally. Self-management education can effectively prevent and control diabetes. We evaluated a localized health promotion model for diabetic patients through a field trial in a general hospital.

METHODS

We enrolled 452 diabetic patients who visited our hospital's cardiology and internal medicine wards and randomly assigned them to two equal groups: intervention and control. The intervention group received initial and periodic education on diabetes management and lifestyle modification, as well as educational materials. The control group received only initial education and phone follow-ups. We measured the following outcomes after 6 and 12 months of discharge: glucose and lipid levels, smoking status, diet quality, rehospitalization rate, treatment cost, quality of life, and work absenteeism. The groups were then compared using chi-square, student t-test, and two-way repeated-measures analysis of variance.

RESULTS

We enrolled 452 patients, randomized into two equal groups, and followed them for one year. Baseline demographic and clinical variables were similar between groups. The intervention group showed a significant reduction in BMI ( = 0.027), fasting blood glucose ( < 0.001), and HbA1c levels ( = 0.002) compared to the control group. The prevalence of hypertension, smoking, sedentary lifestyle, and inappropriate diet was significantly higher in the control group ( = 0.001 for all). The intervention group had fewer hospitalizations, work absences, and medical costs ( < 0.001,  = 0.001, and  < 0.001, respectively). No significant difference was observed in satisfaction rates between the groups.

CONCLUSIONS

Health promotion interventions could improve glucose control and other health indicators and reduce costs for diabetic patients.

摘要

目的

糖尿病是主要的心血管危险因素,是全球主要的非传染性疾病。自我管理教育可有效预防和控制糖尿病。我们通过在一家综合医院进行的现场试验评估了一种针对糖尿病患者的本地化健康促进模式。

方法

我们招募了452名到我院心内科和内科病房就诊的糖尿病患者,并将他们随机分为两组,每组人数相等:干预组和对照组。干预组接受了糖尿病管理和生活方式改变的初始及定期教育,以及教育材料。对照组仅接受初始教育和电话随访。我们在出院6个月和12个月后测量了以下结果:血糖和血脂水平、吸烟状况、饮食质量、再住院率、治疗费用、生活质量和旷工情况。然后使用卡方检验、学生t检验和双向重复测量方差分析对两组进行比较。

结果

我们招募了452名患者,随机分为两组,每组人数相等,并对他们进行了一年的随访。两组之间的基线人口统计学和临床变量相似。与对照组相比,干预组的体重指数(=0.027)、空腹血糖(<0.001)和糖化血红蛋白水平(=0.002)显著降低。对照组的高血压、吸烟、久坐不动的生活方式和不当饮食的患病率显著更高(所有均为=0.001)。干预组的住院次数、旷工天数和医疗费用更少(分别为<0.001、=0.001和<0.001)。两组之间的满意度没有显著差异。

结论

健康促进干预措施可以改善糖尿病患者的血糖控制和其他健康指标,并降低成本。

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