【摘要】 目的 观察标准化代谢性疾病管理中心（MMC）“1+X”管理模式对社区2型糖尿病（T2DM）患者胰岛素抵抗及代谢相关指标的影响，为社区T2DM患者的精准化治疗提供依据。方法 社区T2DM患者分为MMC“1+X”组104例、自我管理组99例。自我管理组由内科医生根据患者病情给予不同药物治疗，并进行常规随访、健康教育及用药指导。MMC“1+X”组在以上治疗方案的基础上，实施MMC标准化管理。两组患者治疗1年后，收集空腹血糖（FPG）、甘油三酯（TG）数据，计算胰岛素抵抗指标甘油三酯葡萄糖指数（TyG）。两组患者治疗1年后，收集血糖、血压、血脂和尿酸（UA）等代谢相关指标，包括FPG、糖化血红蛋白（HbA1c）、收缩压（SBP）、舒张压（DBP）、总胆固醇（TC）、TG、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、UA等，计算血糖、血压、血脂、UA和综合达标率。结果 自我管理组患者治疗1年后TyG为9.25±0.74,MMC“1+X”组患者治疗1年后TyG为8.93±0.61，两组相比，P<0.05。MMC“1+X”组患者治疗1年后FPG、HbA1c、TC、LDL-C、SBP、DBP、UA等代谢相关指标均低于自我管理组患者（P均<0.05）。自我管理组患者治疗1年后血糖、血压、血脂、UA和综合达标率分别为42.4%、46.5%、38.4%、39.4%和5.1%,MMC“1+X”组患者分别为64.4%、68.3%、60.6%、66.3%和16.3%，两组相比，P均<0.05。结论 MMC“1+X”管理模式可有效降低社区T2DM患者的胰岛素抵抗及代谢相关指标，提高综合达标率。更多还原

【Abstract】 Objective To observe the effects of the "1+X" management model of the standardized metabolic disease management center(MMC) on insulin resistance and metabolic-related indicators in community patients with type 2 diabetes mellitus(T2DM), and to provide a basis for the precision treatment of community patients with T2DM. Methods Community patients with T2DM were divided into MMC "1+X" group(n=104) and self-management group(n=99). In the self-management group, physicians gave different medications according to the patients’ conditions, and performed routine follow-up, health education, and medication guidance. On the basis of the above treatment plan, the MMC "1+X" group was implemented with MMC standardized management. After one year of treatment, the fasting blood glucose(FPG) and triglyceride(TG) data of the two groups were collected, and the triglyceride glucose index(TyG), an indicator of insulin resistance, was calculated. After one year of treatment, we collected metabolic related indicators such as blood glucose, blood pressure, blood lipids and uric acid(UA), including FPG, glycosylated hemoglobin(HbA1c), systolic blood pressure(SBP), diastolic blood pressure(DBP), total cholesterol(TC), TG, low-density lipoprotein cholesterol(LDL-C), high-density lipoprotein cholesterol(HDL-C), UA, etc., and calculated blood glucose, blood pressure, blood lipids, UA and comprehensive achievement rate from patients of the two groups. Results After one year of treatment, TyG of the self-management group was 9. 25 ± 0. 74, and TyG of the MMC "1+X" group was 8. 93 ± 0. 61 after one year of treatment, with statistically significant difference between these two groups(P<0. 05). After one year of treatment, the FPG, HbA1c, TC, LDL-C, SBP, DBP, UA and other metabolic related indicators of the MMC "1+X" group were lower than those of the self-management group(all P<0. 05). After one year of treatment, the blood glucose, blood pressure, blood lipid, UA and comprehensive achievement rates of the self-management group were 42. 4%, 46. 5%, 38. 4%, 39. 4% and 5. 1%, respectively, and those of the MMC "1+X" group were 64. 4%, 68. 3%, 60. 6%, 66. 3% and 16. 3%, respectively, with statistically significant difference between these two groups(all P<0. 05) Conclusion The MMC "1+X" management model can effectively reduce insulin resistance and metabolic-related indicators in community patients with T2DM and improve the comprehensive achievement rate.更多还原