Objective:To explore the effect of a new intervention model based on tertiary hospital-close medical union-family doctor graded education guidance on cardiovascular disease risk in patients with type 2 diabetes mellitus.Methods:From the retirees managed by the municipal social security center from 2014 to 2015,type 2 diabetes patients contracted by the hospital's close medical association were selected and divided into intervention group and control group.On the basis of community management,the intervention group was given one-year systematic individualized lifestyle intervention by specialists and nurses,while the control group only received routine community management.Community family doctors were trained twice a year by the specialized team of the tertiary hospital.A total of 456 patients with T2DM whose data were complete were finally studied,including 282 females and 174 males,with an average age of(61.82±0.35)years;among them,168 were in the intervention group and 288 in the control group.The biochemical indexes and cardiovascular disease progression were compared between the two groups before and after follow-up intervention.Results:(1)After the intervention,the blood glucose,blood lipid and blood pressure of all patients decreased significantly compared with the baseline(P＜0.05);(2)There was no significant increase in LDL-C in the intervention group compared to the control group;(3)The risk of coronary heart disease in the control group was 2.53 times higher than that in the intervention group(P＜0.05);(4)The renal function in the intervention group declined slowly,and after correcting the confounding factors,lifestyle intervention was an independent protective factor for the decline in renal function(P＜0.05).Conclusion:The new intervention mode based on tertiary hospital-close medical union-family doctor graded education guidance can effectively reduce the risk of cardiovascular disease in patients with type 2 diabetes.
contracted family doctor servicesclose medical uniondiabetes lifestyle interventioncardiovascular disease
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