【摘要】 目的 探讨糖尿病管理的有效模式，提高糖尿病患者的治疗达标率，减少低血糖发生。 方法 研究对象为2008年5月-2009年5月就诊的2型糖尿病患者356例。测量所有研究对象的空腹血糖、餐后2 h血糖、糖化血红蛋白。观察糖尿病管理后及常规治疗后血糖的变化。 结果 应用糖尿病达标管理软件管理糖尿病患者，血糖达标率明显升高，差异有统计学意义（Plt;0.05）；低血糖的发生率下降，差异有统计学意义（Plt;0.05）。 结论 大多数糖尿病患者的病情控制未达到理想的目标，应用科学的糖尿病达标管理软件进行管理是改善现状的有效方法。【Abstract】 Objective To study the effective management model for diabetes mellitus, promote the treatment results of patients with disease, and reduce the occurrence of hypoglycemia. Methods A total of 356 patients with type 2 diabetes mellitus (T2DM) treated from May 2008 to May 2009 were chosen in this study. Fasting bloods glucose, 2-hour postprandial blood glucose and hemoglobin A1c were detected in all the subjects. Then, the change of glucose level for the management group and the common treatment group was observed. Results The glucose-target-rate of patients managed by diabetes management software was significantly higher than patients in the common treatment group (Plt;0.05), and the occurrence rate of hypoglycemia was also significantly lower (Plt;0.05). Conclusions The control of T2DM for most patients is far from satisfaction. The application of scientific disease care software is effective for improving disease control.
Objective To investigate the mediating effect of phase angle between muscle strength and muscle function in maintenance hemodialysis (MHD) patients, aiming to provide a reference basis for clinical improvement of muscle strength and muscle function in MHD patients. Methods Random sampling was used to collect patients undergoing outpatient MHD in the Wenjiang Hemodialysis Room of the Department of Nephrology, West China Hospital, Sichuan University between September and December 2023 as the subjects of this study. Muscle strength was assessed by handgrip strength, muscle function was assessed by Short Physical Performance Battery (SPPB), and phase angle was measured by bioelectrical impedance analysis. The mediating effect of phase angle between muscle strength and muscle function was analyzed. Results A total of 239 MHD patients were included, including 125 males (52.3%) and 114 females (47.7%). The mean phase angle of MHD patients was (5.77±1.17)°, 89 patients (37.2%) showed decreased muscle strength, and 109 patients (45.6%) showed muscle hypoplasia. Spearman’s correlation analyses showed that phase angle was significantly and positively correlated with both handgrip strength and SPPB in MHD patients (P<0.001). The results of mediation effect analysis showed that handgrip strength was able to positively predict phase angle (β=0.535, P<0.001); handgrip strength was able to positively predict SPPB (β=0.481, P<0.001); phase angle was able to positively predict SPPB (β=0.296, P<0.001); and when both handgrip strength and phase angle entered in the regression equation, both handgrip strength (β=0.392, P<0.001) and phase angle (β=0.165, P<0.05) could positively predict SPPB. Phase angle in MHD patients partially mediated the association between muscle strength and muscle function, with the mediating effect accounting for 32.5% of the total effect. Conclusions There is a close relationship between phase angle, muscle strength and muscle function in MHD patients, and muscle strength can affect muscle function directly or indirectly through phase angle. Medical professionals should pay attention to the muscle function of MHD patients and further improve their muscle function by improving their phase angle and muscle strength.