Evaluation on the effetc of comprehensiv e management of patients with early diabetic nephropathy in a Community / 上海预防医学

ABSTRACT

Objective To evaluate the effect of comprehensive management of patients with early diabetic nephropathy in community . Methods A randomized controlled trial was adopted and 201 patients with early diabetic nephropathy in a community were randomized into two groupsintervention group(n=101) and control group(n=100).The intervention group received comprehensive intervention and standardized management , while the control group received routine medical services of diabetes mellitus.The changes of related indicators were compared between the patients in two groups before and after twelve months of intervention . Results After twelve months of intervention , the patients in the intervention group showed greater improvement in cognition , attitude and self-management behavior for the disease compared with the patients in the control group .The values of disease-related knowledge and attitude in the intervention group increased by 1 .20 points and 0 .52 points significantly more than those in the control group .Medication compliance , weekly exercise time , communication between doctors and patients in the intervention group increased by 0.19 points, 0.74 times/week and 0.44 points significantly more than those in the control group ( all P <0 .05 ) .Two-hour postprandial blood glucose , glycosylated hemoglobin decreased by 1.13 mmol/L and 0.42%respectively , significantly more than those in the control group.Urinary albumin/urine creatinine, systolic blood pressure decreased by 26.81 mg/g and 3 mmHg respectively, significantly more than those in the control group (all P<0.05). Conclusion Compared with the routine medical services of diabetic nephropathy, the comprehensive intervention and standardized management of early diabetic nephropathy in community is more effective on the improvement in disease-related cognition, attitude and self-management behavior , as well as the biological indexes such as urine albumin/urine creatinine , postprandial blood glucose and blood pressure .