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目的 在社区开展对糖尿病高危人群健康管理,提高社区卫生人员预防糖尿病的知识和技能,增强糖尿病高危人群自我保健能力,降低糖尿病患病风险.方法 在天津市的2个行政区的6个社区建立基地,采用糖尿病风险筛查技术,筛查糖尿病高危人群307名.采用健康管理技术对该人群进行三个月强化及九个月跟踪的健康管理.运用SPSS13.0统计软件包进行数据分析,对被观察者主要体检指标干预前后进行对比分析,连续变量进行配对t检验、分类变量进行配对列联表x2检验,P＜0.05为差异有统计学意义.结果 通过健康管理技术的实施,分析管理前后的各项指标和数据,包括能量摄入(管理前1989.8千卡,管理后1766.4千卡,t=6.84,P＜0.05)、有效运动量(管理前120.4千卡,管理后157.5千卡,t=-5.00,P＜0.05)、体重(管理前73.0 kg,管理后71.5 kg,t=6.92,P＜0.05)、收缩压(管理前130.4 mm Hg,管理后124.6 mm Hg,t=8.36,P＜0.05,1 mm Hg=0.133 kPa)、舒张压(管理前81.8 mm Hg,管理后78.4 mm Hg,t=7.40,P＜0.05)、血清胆固醇(管理前5.21 mmol/L,管理后5.08 mmol/L,t=2.73,P＜0.05)、空腹血糖(管理前6.4 mmol/L,管理后5.8mmol/L,t=16.37,P＜0.05)、餐后2h血糖(管理前7.7 mmol/L,管理后6.9 mmol/L,t=9.67,P＜0.05),都有明显下降,糖尿病的危险因素得到有效控制.结论 在社区开展健康管理是预防和遏制糖尿病发生的有效途径.

Objective To assess the effects of health management on high-risk diabetic populations.Methods A total of 307 diabetic high-risk adults from 6 communities of Tianjin were recruited by using diabetes risk screening technology.Three-month intensive health management and nine-month follow-up were conducted in this participants.Paired t test for continuous variables and paired contingency table x2 test were used for data analysis.Results Energy intake (1989.8 vs.1766.4 kcal,t =6.84,P ＜0.05),effective exercises (120.4 vs.157.5 kcal,t =-5.00,P ＜ 0.05),body weight (73.0 vs.71.5 kg,t =6.92,P ＜0.05),systolic blood pressure (130.4 vs.124.6 mm Hg (1 mm Hg =0.133 kPa),t =8.36,P ＜0.05),diastolic blood pressure (81.8 vs.78.4 mm Hg,t =7.40,P ＜ 0.05),serum total cholesterol (5.21 vs.5.08 mmol/L,t =2.73,P ＜ 0.05),fasting plasma glucose (6.4 vs.5.8 mmol/L,t =16.37,P ＜ 0.05)and 2 h postprandial blood glucose (7.7 vs.6.9 mmol/L,t =9.67,P ＜ 0.05) were significantly improved after the intervention.Conclusions Community-based health management may provide an effective way to prevent and control the risk factors of diabetes.