EVALUATION OF A STRUCTURED TEACHING AND TREATMENT PROGRAM FOR TYPE-2 DIABETES IN GENERAL-PRACTICE IN A RURAL AREA OF AUSTRIA
EVALUATION OF A STRUCTURED TEACHING AND TREATMENT PROGRAM FOR TYPE-2 DIABETES IN GENERAL-PRACTICE IN A RURAL AREA OF AUSTRIA
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DOI：
10.1111/j.1464-5491.1995.tb00491.x
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发表时间：
1995-04-01
影响因子：
3.5
通讯作者：
KREJS, GJ
中科院分区：
文献类型：
--
作者：
PIEBER, TR;HOLLER, A;KREJS, GJ
在一项前瞻性对照研究中，对非胰岛素治疗的2型糖尿病患者的治疗和教学计划的有效性进行了评估。在奥地利南部的一个农村地区，来自7个全科诊所的53名患者参加了一个结构化方案（干预组），来自7个全科诊所的55名患者作为对照组。6个月后，干预组体重减轻2.6 kg (1.6 ~ 3.7 kg, p < 0.001)，随访时两组HbA（1c）差异为0.92% （0.23 ~ 1.61%,p < 0.01）。干预组患者收缩压（-16.6 mmHg）和舒张压（-11.1 mmHg）、血清甘油三酯（-0.63 mmol l(-1)）和血清胆固醇（-0.40 mmol l(-1)）均显著降低（p < 0.006）。参与教学计划后，愈伤组织形成和指甲护理不良的患者数量明显减少（p < 0.001）。在对照组中，没有观察到体重、代谢控制或糖尿病足并发症危险因素的减少。干预组（-33英镑）和对照组（+30英镑）的每位患者和年计算医疗保健费用下降，主要是由于两组口服降糖药处方的变化。根据《圣文森特宣言》，该规划可能是提高糖尿病护理整体质量的有效和有益的模式。
The efficacy of a treatment and teaching programme for non-insulin-treated Type 2 diabetic patients in general practice was evaluated in a prospective, controlled study. In a rural area in southern Austria, 53 patients from seven general practices participated in a structured programme (intervention group) and 55 patients from seven general practices without the programme served as the control group. After 6 months the weight reduction in the intervention group was 2.6 kg (1.6-3.7 kg, p < 0.001) and the difference in HbA(1c) between the groups was 0.92 % (0.23-1.61 %, p < 0.01) at follow-up. Systolic (-16.6 mmHg) and diastolic (-11.1 mmHg) blood pressure, serum triglycerides (-0.63 mmol l(-1)), and serum cholesterol (-0.40 mmol l(-1)) were reduced significantly in the intervention group (p < 0.006). The number of patients with callus formation and poor nail care decreased significantly after participating in the teaching programme (p < 0.001). In the control group no reduction in body weight, metabolic control or in risk factors for diabetic foot complications were observed. Calculated health care costs per patient and year decreased in the intervention group (pound -33) and increased in the control group (pound +30) mainly due to changes in prescription of oral hypoglycaemic agents in both groups. This programme may be an efficient and helpful model to increase overall quality of diabetes care according to the St Vincent Declaration.