Effect of patient motivation model on blood glucose management in patients with type 2 diabetes mellitus in community / 中华内分泌代谢杂志

Objective To investigate the effect of patient motivation model on blood glucose and quality of life in community type 2 diabetes mellitus ( T2DM) patients. Methods The study recruited 258 eligible adult patients who were residents with health records from Waigang community health centers of Shanghai Jiading District. The subjects were randomly divided into incentive group ( n= 123 ) and control group ( n= 135 ) . We established a cooperative pathway between community health care centers and general hospital, trained community health workers, equipped with the necessary clinical drugs, and finally, the Advance System for Diabetes Management was used to carry out the tele-medicine. The type 2 diabetic patients, who were set goals in blood glucose, managed by the general practitioners, the daily health behaviors of the patients were regulated. The study group received the incentives if they can obtain or/and maintain the ideal level of HbA1C during the 1-year study period. The control group would not receive any incentives but would be provided with diabetes education booklet and to follow group educational courses for diabetes mellitus control as usual. Results After 12 months, there were significant differences in HbA1C , fasting blood glucose, and the on-target rate of HbA1C in both two groups as compared with the baseline levels(P<0.05). In the investigation of quality of life( QOL) , we found a significant differences in the scores of total QOL, the degree of satisfaction, and the degree of influence between the incentive group and the control group in one year after intervention( P<0.05) . Conclusion The objective motivation model seems to exert a positive effect on blood glucose control and self-management for those with T2DM.

Quando a satisfação autorrelatada do paciente com a prótese implantossuportada mandibular influencia na colocação de uma prótese total fixa na maxila: os benefícios do planejamento e colocação 3D baseados na TCFC e nos guias estereolitográficos – acompanhamento de dois anos e 11 meses / When the self-reported patient satisfaction with implant-supported mandibular denture influences on the use of implant-supported maxillary prostheses: the benefi ts of a 3-D implant planning and placement based on CBCT and stereolithographic guides – two year and 11-month follow-up

Este relato mostra um paciente de 72 anos de idade onde sua prótese total inferior sobre implantes motivou-a para usar uma prótese total fixa na maxila. Após os procedimentos de TCFC e protéticos no plano de tratamento, guias estereolitográficos foram construídos para uma colocação de implantes dentários sem levantamento de retalho. Cinco implantes foram colocados nas regiões 14, 13, 11, 22, e 24 com torque de inserção de 32 Ncm. A prótese total fixa definitiva foi entregue em até 48 horas. Após dois anos e 11 meses, não foram registradas complicações. Quando adequadamente indicada, a cirurgia virtual guiada tem se tornado uma realidade efetiva para pacientes idosos.

This case reports on a 72 years-old patient whose complete mandibular implant-supported prosthesis motivated her to use a fi xed appliance in the maxilla. After CBCT and prosthodontic procedures for treatment planning, stereolithographic guides were constructed for a flapless dental implant placement. Five implants were placed in the regions of 14, 13, 11, 22 and 24 with a 32 Ncm insertion torque. The final maxillary implant-supported prosthesis was delivered until 48 hours. After two years and 11 months, no complications were reported. When properly indicated, virtual guided surgery has become an effective possibility for elderly patients.