Zhongguo quanke yixue (Sep 2024)
The Effectiveness of Three Division Management for Diabetes Patients with Different Disease Courses
Abstract
Background Diabetes has a high incidence rate and many complications, which was an urgent public health problem, but the prevention and management is still not ideal. Objective To observe the effect of Three Division management on metabolic indicators and self-management levels of diabetes patients with different courses of disease. Methods One hundred and 81 type 2 diabetes patients from April 2021 to April 2022 were managed by the mode of Three Division management and followed up for more than 6 months in Shenzhen Hospital Guangzhou University of Chinese Medicine (Futian). The patients were grouped according to the course of disease (Group A: course of disease<1 year; Group B: course of disease 1-5 years; Group C: course of disease >5-10 years; Group D: course of disease>10 years) ; In outpatient, the three-division team composed of traditional Chinese medicine practitioners, endocrinologists and caregivers carries out comprehensive treatment such as physique identification, complication screening, medicine, food, exercises and emotion intervention; When patients are at home, the caregivers carry out intelligent management through intelligent Glucose meter equipment and mobile phone APP. We collected changes in blood glucose and body weight indicators in patients with different disease courses after six months of management. Additionally, we used a questionnaire to gather common issues in patient self-management and fill out the Summary of Diabetes Self-Care Activities Measure-6 (SDSCA-6) . Results Through the management of the Three Division management, Group A patients showed significant improvement in reducing fasting blood glucose and postprandial 2-hour blood glucose after the intervention (P<0.05). The BMI and waist circumference of groups A, B, C, and D were all reduced compared to before the intervention (P<0.05). Common dietary issues in patient self-management included an unreasonable dietary structure (38.12%), common exercise issues included insufficient exercise volume or intensity (36.46%), and common monitoring issues included insufficient monitoring (37.02%). The self-management levels of groups A, B, C, and D in the four dimensions of "healthy eating" "self-monitoring" "adherence to medical advice" and "education and communication" all improved compared to before the intervention (P<0.001) . Conclusion The three division management can improve the self-management ability of diabetes patients and play a good comprehensive role in diabetes. Clinical practice should particularly emphasize the management of patients with a diabetes course of less than one year.
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