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Objective:To explore the application advantages of hospital-community linkage network blood glucose management model for elderly type 2 diabetes patients in community in order to supply reference for improve patients′ qualitye of life.Methods:This study was a randomized controlled study. A total of 84 elderly patients in Huangpu Community Hospital of Guangzhou from February to September 2022 were selected and divided into control group and intervention group by a table of random numbers. The control group adopted the hospital community linkage management model, and the intervention group followed the network management mode on the basis of the routine management. After 6 months of intervention, we compared the level of fasting blood glucose, blood glucose two hours after meal and glycosylated hemoglobin, and the scores of the Summary of Diabetes Self-Care Activities (SDSCA), Diabetes Specificity Quality of Life Scale(DSQL) between the two groups to illustrate the application advantages.Results:There were no significant differences in blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin between the intervention and control groups (all P>0.05). After 6 months of intervention, the blood glucose two hours after meal, fasting blood glucose and glycosylated hemoglobin of the intervention group were (9.25 ± 2.87) mmol/L, (6.07 ± 0.69) mmol/L and (7.04 ± 1.59) %, respectively, which were lower than those of the control group (11.04 ± 3.75) mmol/L, (6.57 ± 0.95) mmol/L and (8.02 ± 2.25)%. The differences were statistically significant ( t = 2.45, 2.76, 2.30, all P<0.05). After 6 months of intervention, the scores of SDSCA scale and DSQL scale were (34.21 ± 10.43) and (135.64 ± 10.71) points, which were higher than (29.12 ± 7.36) and (145.85 ± 10.33) points in the control group, and the differences were statistically significant ( t = 2.58, 4.44, both P<0.05). Conclusions:The hospital-community linkage network management model can improve the blood glucose level of elderly patients with type 2 diabetes mellitus in the community and has a positive effect on improving self-management behavior ability and improving quality of life.
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Objective:To systematically evaluate the qualitative studies on the decision dilemma of blood glucose management during pregnancy in patients with gestational diabetes mellitus, so as to provide reference for the subsequent formulation of intervention strategies.Methods:The qualitative studies on the decision dilemma of blood glucose management during pregnancy in patients with gestational diabetes mellitus in the Cochrane Library, CINAHL, EMbase, PubMed, PsycINFO, ProQuest, Web of Science, China National Knowledge Internet, Wanfang, VIP and Chinese Biomedical Database were searched from inception to May 2022. The JBI Critical Appraisal Tool for qualitative studies in Australia (2016) was used to evaluate the literature quality, and research results were summarized and integrated by integrating methods.Results:A total of 13 studies were included, 56 themes were extracted, and they were summarized into 9 categories, forming 3 integrated results as following, lack of personalized and professional information on blood glucose management, worring about the influence of blood glucose management on the health of mothers and children, conflict between daily life and blood glucose management plan.Conclusions:Health care workers should provide gestational diabetes mellitus patients with adequate personalized professional information support on blood glucose management to facilitate scientific decision-making during pregnancy, and also analyze the benefits and risks of different decisions for patients to help them make the best decision and strengthen their external support system to help them implement blood glucose management decisions.
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Objective:To evaluate and rank the effects of different non-pharmaceutical interventions on the management of blood glucose in children and adolescents with type 1 diabetes by Bayesian network Meta-analysis.Methods:Computer search for PubMed, Web of Science, Cochrane Library, Embase, CINAHL, China Biomedical Literature Database, China Knowledge Network, Wangfang Data and VIP Database, China and the United States Clinical Registration Center, the search time limit is from the establishment of each database to December 2020. Use WinBUGS, GeMTC, Stata software for blood glucose management data analysis.Results:Finally, 37 articles were included, with a total of 4 188 cases, involving 14 non-pharmaceutical intervention programs. The results of the network Meta-analysis showed that when different non-pharmacological interventions were used, the effectiveness of blood glucose management in children and adolescents with type 1 diabetes was ranked as follows: peer support education first, cognitive behavioral therapy second, advanced diabetes education third, family support intervention fourth, self guided intervention (GSD-Y) fifth, case training sixth, positive psychological intervention seventh, mobile phone based remote intervention eighth, diabetes education ninth, supportive consultation tenth, network based remote intervention eleventh position, multi-system therapy multi system therapy twelfth, conventional nursing thirteenth, motivational interview fourteenth.Conclusions:The available evidence shows that peer support education and cognitive behavioral therapy show certain advantages in blood glucose management in children and adolescents with type 1 diabetes, while motivational interviews perform the worst. Future research will further consider other potential benefits of non-pharmacological interventions, such as emotional health and diabetes self-management behavior.
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OBJECTIVE To intr oduce multidisciplinary collaborative blood glucose management mode （hereinafter referred as to blood glucose management mode of the whole hospital ）of the whole hospital with the participation of clinical pharmacists ，and to evaluation it effects on the blood glucose management of perioperative diabetes patients. METHODS The process of blood glucose management mode of the whole hospital in Drum Tower Hospital Affiliated to Medical School of Nanjing University and the work content of clinical pharmacists were introduced. Three hundred patients with type 2 diabetes mellitus who underwent elective surgery were included and randomly divided into general consultation group （control group ）and hospital-wide glucose management group （intervention group ）. The effect of glucose management and indicators such as preoperative waiting time and total length of stay were compared between 2 groups. RESULTS In the blood glucose management team of the whole hospital ，the physicians，clinical pharmacists and nurses of blood glucose management in endocrinology department were the core members ，and the management process was divided into initial management ，daily management ，discharge management and follow-up. As the team secretary ，the clinical pharmacists were mainly responsible for daily summarizing and managing the blood glucose level and special conditions of patients ，regularly evaluating the management effect ，carrying out pharmaceutical ward rounds ，medical order review， pharmaceutical care ， timely assessing the blood glucose of patients and guiding the rational use of drugs. Compared with before intervention ， after 3 days ofintervention，the levels of fasting plasma glucose （FPG）and postprandial blood glucose （PBG） were decreased significantly in 2 groups（P＜0.05）；intervention group was significantly lower than control group （P＜0.05）. Compared with control group ， the fluctuation of blood glucose in intervention group was significantly reduced （P＜0.05），standard deviation of blood glucose had reached the targeted control level ， and the postprandial glucose excursion and the largest amplitude of glycemic excursion were close to the targeted control level ；the rate of bl ood glucose reaching the standard before operation and at discharge were significantly increased （P＜0.05）；the preoperative waiting time and hospitalization days were significantly shortened （P＜0.05）. CONCLUSIONS The multidisciplinary collaborative blood glucose management mode of the whole hospital with the participation of clinical pharmacists can control the blood glucose level of diabetic patients in the perioperative period more stably and effectively ，and has practical significance for the disease treatment and prognosis of patients.
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Objective To investigate the current state of sedation,analgesia and blood glucose management in intensive care units (ICUs) of county hospitals in Guizhou Province of China,and to provide the evidences for improving quality control in critical care medicine.Methods In March 2018,3-4 ICUs of hospitals in every prefecture (one hospital per county) in Guizhou Province were visited to do the field survey.The patients' nursing records within 24 hours after ICU admission were reviewed,and the information such as gender,age,major diagnosis at the ICU admission,the time of admission,were collected.Moreover,the conditions about sedation and analgesia drug use and monitoring,blood pressure,blood glucose as well as and the usage of insulin and ventilator were recorded.Because not all the needed information of every ICU or patient was obtained,only the numbers of the ICUs and patients whose required information had been obtained were analyzed.Results Twenty-eight county hospitals in nine prefectures of Guizhou Province and 152 ICU patients were surveyed.There was a median of 5 (4,7) patients stayed in every ICU on the day of survey.A total of 152 patients were enrolled,with 102 male (67.1％) and 50 female (32.9％);the median age was 65.0 (51.5,74.8) years old;the major diagnosis at ICU admission was mainly cerebral diseases which accounted for 50.0％ (76/152),and the second place was digestive system diseases which accounted for 13.8％ (21/152);53.8％ (78/145) of patients were admitted to ICUs during 08:00-18:00.The percentages of ICUs which had patients received sedation and analgesia were 92.6％ (25/27) and 88.9％ (24/27) respectively,while only 44.4％ (12/27) and 18.5％ (5/27) of them were evaluated the depth of sedation and the level of pain respectively.There was 49.0％ (71/145) of patients received sedation,and 33.8％ (24/71) of them was evaluated by sedation scores;49.7％ (72/145) of patients received analgesia,and 13.9％ (10/72) of them were evaluated by pain scores.The proportions of invasive mechanical ventilation in the patients with sedation or analgesia were both higher than those in the patients without sedation or analgesia [sedation compared with non-sedation:85.9％ (61/71) vs.21.6％ (16/74),analgesia compared with non-analgesia:87.5％ (63/72)vs.19.2％ (14/73),both P ＜ 0.01].The incidence of hypotension was similar between the sedated patients and the non-sedated patients [55.9％ (38/68) vs.40.3％ (29/72),P ＞ 0.05],while the incidence of hypotension was higher in the patients with analgesia as compared with that in the patients without analgesia with significant difference [56.9％ (41/72) vs.38.2％ (26/68),P ＜ 0.05].Within 24 hours after ICU admission,there were 40.7％ (59/145) and 5.5％ (8/145)of patients had hyperglycemia (random blood glucose level ≥ 11.1 mmol/L) or hypoglycemia (random blood glucose level ＜≤ 3.9 mmol/L) respectively.No insulin was used to control the blood glucose level in the patients who had hypoglycemia or did not have hyperglycemia.However,only 23.7％ (14/59) of patients with hyperglycemia were treated with insulin,the initiation of insulin therapy was triggered when median blood glucose level was 19.8 (16.8,24.5) mmol/L.Conclusions The evaluation of analgesia and sedation in the ICUs of county hospitals in Guizhou Province was seriously inadequate and needed to be strengthened urgently.Moreover,the strategy of blood glucose management was also needed to be improved.
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Objective@#To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia.@*Methods@#A prospective, cross-controlled, quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019. Patients with conventional blood glucose management served as the control group, and SGC blood glucose management was used as the intervention group. The enrolled patients were interchanged between the two groups every 24 h, and the end point was 96 h. The differences in blood glucose management quality indicators between the two groups were compared, including the average blood glucose level, the highest and lowest blood glucose level, the average blood glucose monitoring interval, and the accumulated insulin dosage. SPSS 23.0 was used to analyze the data. The paired t test was used for the normal distributed data. Otherwise, two nonparametric correlation sample tests was used. A P<0.05 was considered statistically significant.@*Results@#A total of 41 patients enrolled in this study during the study period. The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±1.42)mmol/L vs (10.02 ±1.49)mmol/L, P< 0.01]. The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91, P=0.023). The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60, P< 0.01). However, the frequency of hypoglycemia, the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0, 5) vs 0 (0, 2), P< 0 01; 1 36 ±0 23 vs 1 89 ±0 28, P< 0.01; and (139.61 ±77.06)U vs (107.49 ±64.41)U, P<0.01].@*Conclusions@#SGC can optimize the control of blood glucose in the target blood glucose range, but it can easily lead to mild hypoglycemia, and to a certain extent increases the workload of medical staff.
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Objective To investigate the effect of space glucose control (SGC) on the quality of blood glucose management in ICU patients with stress hyperglycemia.Methods A prospective,cross-controlled,quasi-trial was conducted to observe patients with ICU-induced stress hyperglycemia between January 2018 and January 2019.Patients with conventional blood glucose management served as the control group,and SGC blood glucose management was used as the intervention group.The enrolled patients were interchanged between the two groups every 24 h,and the end point was 96 h.The differences in blood glucose management quality indicators between the two groups were compared,including the average blood glucose level,the highest and lowest blood glucose level,the average blood glucose monitoring interval,and the accumulated insulin dosage.SPSS 23.0 was used to analyze the data.The paired t test was used for the normal distributed data.Otherwise,two nonparametric correlation sample tests was used.A P＜0.05 was considered statistically significant.Results A total of 41 patients enrolled in this study during the study period.The average blood glucose value in the intervention group was significantly lower than that in the control group [(8.60 ±l.42)mmol/L vs (10.02 ±1.49)mmol/L,P＜0.01].The frequency of hyperglycemia was lower than that of the control group (16.59 ±8.56 vs 18.73 ±7.91,P=0.023).The frequency of blood glucose value in the target blood glucose range was significantly higher than that of the control group (53.07±19.11 vs 29.44±19.60,P＜ 0.01).However,the frequency of hypoglycemia,the frequency of blood glucose monitoring and the accumulated insulin dosage in the intervention group were higher than those in the control group [1 (0,5) vs 0 (0,2),P＜ 0 01;1 36 ±0 23 vs 1 89 ±0 28,P＜ 0.01;and (139.61 ±77.06)U vs (107.49 ±64.41)U,P＜0.01].Conclusions SGC can optimize the control of blood glucose in the target blood glucose range,but it can easily lead to mild hypoglycemia,and to a certain extent increases the workload of medical staff.
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Objective To explore the effect of " hospital informationized blood glucose management" on perioperative diabetic patients. Methods Three hundred patients with type 2 diabetes mellitus, who underwent selective operations from orthopedics, general surgery, urological surgery, and thoracic surgery were divided into two groups: 150 cases of blood glucose information management group and 150 cases of traditional blood glucose monitoring and management group. The blood glucose on target rate, percent of hypoglycemic events, percent of hyperglycemic events, the blood glucose level on the first postoperative day, the average hospitalization day, perioperative infection rate were evaluated for efficacy. Results The blood glucose on target rate in informationized blood glucose management group was significantly higher than that of the control group [(52.52 ± 18.31)%vs (14.88 ± 8.39)%, P＜0.01]. The frequency of hyperglycemia, the average daily blood glucose, the average blood glucose on fasting, after three meals and at night, the fasting and postprandial blood glucose level on the first postoperative day in informationized blood glucose management group were significantly lower than that of the control group [( 45. 31 ± 18.87)%vs (84.41±8.86)%, (8.59±1.34 vs 12.47±2.37) mmol/L, (7.33±1.41 vs 10.01±1.99)mmol/L, (8.89 ±2.34vs13.61±3.47)mmol/L,(9.47±1.94vs13.46±2.77)mmol/L,(9.40±2.72vs13.28±2.94)mmol/L, (8.28±2.11vs11.31±2.89)mmol/L,(8.29±2.51vs11.58±3.52)mmol/L,(8.25±3.67vs17.65±19.68) mmol/L, all P＜0.01]. In addition, the average hospitalization day of the informationized blood glucose management group was significantly shorter than that of the control group [(16±7 vs 21±15)d, P＜0.05]. The infection rate of the management group and the control group were 41. 2% and 58. 8% respectively. There was no significant difference between two groups (P＞0.05). Conclusion The " hospital informationized blood glucose management" is simple and practical, which may significantly improve the rate of blood glucose control in each period, reduce the average hospitalization day, and decrease perioperative infection tendency.
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Objectivde To explore the efficacy of i-GMS applied to the diabetes patient outside the hospital.Methods Totally 80 type 2 diabetes mellitus patients were divided into an experiment group (Group A) and a control group (Group B).Group A executed blood glucose monitoring by Glucose Management App and intelligent blood glucose meter (personal version),and Group B completed monitoring by some portable blood glucose meter.Telephone follow-up was performed once a week,and the two groups were compared on glycated albumin (GA) value 3 weeks after discharging,values of HbA1c,FPG and PG2h 3 months after,the times of blood glucose monitoring and hypoglycaemia as well as the patient satisfaction over the glucose management.Results Group A had the values of GA,HbA1c,FPG and PG2h significantly lower than those of Group B (P＜ 0.05).The times of glucose monitoring and patient satisfaction in Group A were statistically higher than those of Group B,while the incidence rate of hypoglycaemia of the former was lower than that of the latter (P＜0.05).Conclusion I-GMS proves efficient when used for glucose self monitoring and management of the type 2 diabetes mellitus patient.
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Objective To analyze the blood glucose levels and related data of inpatients of different clinical departments, so as to provide a basis for normalized management of blood glucose in hospital. Methods Medical records of 1 726 discharged patients from 9 different clinical departments of Changhai Hospital in November 2014 were retrospectively analyzed using medical record inquiry system. The data included admission blood glucose, metabolic indexes, hospital stay and hospitalization expenses. The abnormal blood glucose and related factors were analyzed. Results We found that 99.19% (1 712) of the 1 726 inpatients had their blood glucose monitored once at least. According to their past medical history and blood glucose levels on admission or during hospitalization, 42.76% (738) patients had pathoglycemia. Endocrinology department (73.79%,76/103), geriatrics department (54.17%, 13/24) and pancreatic surgical department (50.54%, 93/184) had more pathoglycemia patients than other departments. The patients with newly discovered pathoglycemia (393) accounted for 22.77% of the inpatients, and the hospital stay and hospitalization expenses in these patients were significantly higher than patients with diabetes and impaired glucose regulation (IGR) and those with normal blood glucose (P<0.01). The levels of serum triglyceride (TG) and blood urea (BUN) of diabetic and IGR inpatients were significantly higher than patients with newly discovered high glucose and normal glucose (P<0.01); the levels of high density lipoprotein cholesterol (HDL-C) in diabetic and IGR inpatients and those with newly discovered pathoglycemia were significantly lower than that in those with normal blood glucose (P<0.01), but there was no significant difference between the former two groups. Conclusion Newly discovered hyperglycemia during hospitalization should not be overlooked. The blood glucose monitoring of high risk population should be reinforced on admission and during hospitalization, and a standard management of hyperglycemia should be established.
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Objective To explore the effect of the team of diabetes care specialists on the management of blood glucose for clinical nurses. Methods The hospital formed a team of diabetes care specialists , they designed a questionnaire of the diabetes care then surveyed the clinical nurses. According to the survey, the team organized the training program for 2 months and compared the result of the training. Result The differences of these five dimensions between before and after training were statistically significant (P﹤0.05). Conclusion The training can greatly improve the monitoring and management of blood glucose critical values and the technical of diabetes nursing.
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Today,more and more patients with diabetes are requiring surgical intervention.Not only the metabolic disturbance of carbohydrate will be aggravated by surgical stress,but also the risk of perioperative complications and mortality have been greatly increased in patients with diabetes.Therefore,a complete preoperative assessment and blood glucose management of preoperative,intraoperative,and postoperative periods are needed to get full assurance for diabetic patients to undergo surgery and to pass through the perioperative period smoothly.