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目的 评价在社区通过“知己健康管理”模式进行饮食及运动综合管理的效果.方法 社区慢性病管理团队运用“知己健康管理”模式,以知己能量监测仪、“知己生活方式疾病综合防治软件”为工具对饮食和运动实施量化管理,对585例糖尿病患者进行3个月强化期的综合干预,包括合理膳食、科学运动、合理用药、健康教育等一对一个性化的健康指导.比较管理前后体重、体质指数、腰围、血压、空腹血糖、餐后2h血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇,总运动量、有效运动量、有效运动次数、有效运动时间、有效运动/体重、膳食摄入量,空腹血糖达标率、餐后2h血糖达标率、糖化血红蛋白达标率等相关指标的变化.结果 585例2型糖尿病患者中男性240例,女性345例；平均年龄(64.4±9.1)岁.强化管理后患者体重、体质指数、腰围、收缩压、舒张压、空腹血糖、餐后2h血糖、糖化血红蛋白、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇均有明显的改善,差异有统计学意义(t=20.35、20.34、23.74、14.06、12.35、13.35、16.50、9.90、7.53、6.37、-3.74、4.91,均P＜0.05).饮食习惯较管理前有改善的有321例,占总人数的54.8％,管理后有效运动量、有效运动时间、有效运动次数、有效运动量/体重、膳食摄入量均有明显的改善,差异有统计学意义(t=-7.44、-7.91、-5.60、-8.41、5.21,均P＜0.05).管理后空腹血糖达标率由54.2％提高到80.1％,餐后2h血糖达标率由60.4％提高到87.8％,糖化血红蛋白达标率由58.9％提高到77.9％,强化管理后的达标率较管理前均有明显的提高,差异有统计学意义(x2=88.21、109.31、39.97,均P＜0.05).结论 “知己健康管理”模式在社区糖尿病综合干预管理中是一种有效的方法,有利于提高糖尿病的管理效果.

Objective To evaluate the effects of known-to-have health management on diabetes patients.Methods A total of 585 diabetic patients from Desheng Community of Beijing received an intensive health management for 3 months,including diet intervention,physical exercises,medication,health education and individual health guidance.Body weight (BW),body mass index (BMI),waist circumference (WC),blood pressure (BP),fasting blood glucose (FBG),2-h postprandial blood glucose (PBG),glycated hemoglobin A1C (HbA1 c),total cholesterol (TC),triglycerides (TG),high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C),total physical exercises,effective physical exercises,effective physical exercise ratio to BW and dietary intake were compared before and after the intervention.Results Of 585 patients with type 2 diabetes mellitus,240 were male and 345 were female (average age (64.4 ± 9.1) years old).BW,BMI,WC,systolic blood pressure,diastolic blood pressure,FBG,2-h PBG,HbA1c,TC,TG,HDL-C,LDL-C,amount and time or frequency of effective physical exercises,effective physical exercise ratio to BW and total dietary intake were significantly improved after intensive health management (t values were 20.35,20.34,23.74,14.06,12.35,13.35,16.50,9.90,7.53,6.37,-3.74,4.91,-7.44,-7.91,-5.60,-8.41 and 5.21,respectively ; all P ＜ 0.05).More healthy eating habits were found in 321 subjects (54.8％).Those having normal FBG were increased from 54.2％ to 80.1％ following known-to-have health management,with 2-h PBG from 60.4％ to 87.8％ and HbA1c from 58.9％ to 77.9％ (x2 values were 88.21,109.31 and 39.97,respectively; all P ＜ 0.05).Conclusion Known-to-have management may provide an effective tool for community diabetics.