It has broad spaces that diabetes of community is managed

It has broad spaces that diabetes of community is managed
It has broad spaces that diabetes of community is managed
Health newspaper office and Chinese Medical Association diabetic credit will sponsor together and Luo diagnose ' Products) The diabetic community's doctor who Shanghai Co., Ltd. supports manages the training project to launch in Shanghai on November 26. This project aims at improving community's doctor's blood glucose and measuring competence and optimizes blood glucose and manage quality, have already been classified as the Ministry of Public Health, Ministry of Science and Technology and the Chinese Technology Association and launch " Hygiene science and technology enters the community " Project. Know Vice Chairman, the second army medical university Changhai hospital endocrine head of the department Zou Da and enter the professor in Chinese Medical Association's diabetic credit, the second Shi Yong of division of endocrinology of long march hospital of army medical university Professor Quan, medical center Professor Wang WeiQing of metabolic disease of the endocrine of Shanghai Rui Jin hospital, have given lessons for 70 community doctors that are chosen from every district of Shanghai. Shanghai takes an early lead Huang Hong, Deputy Secretary of Shanghai Municipal Health Bureau Party Committee, introduces at the training meeting, the aging population of Shanghai is becoming more obvious, after 5 years, there is a person over 60 years old in about every 3 people. The government of Shanghai attaches great importance to the management of chronic disease, has launched the diabetic community's comprehensive management since beginning of this century, and research and develop community diabetic's differentiated control and dynamic monitoring system. In 2004, Shanghai took the lead in issuing diabetes of community and preventing and curing the regulatory file in the whole country - -<>,Confirm the whole the intersection of crowd and health education, high-risk group sift check and dangerous factor intervene and the intersection of patient and diabetes of community of standardized management prevent and cure the tactics. By the end of 2009, 18 districts (county) in the whole city 240 piece city community and it is rural and at the basic level for hygiene service organization last diabetes and diabetes patient managements previous all, it is up to 199545 to manage the number of people, among them the number of the diabetic is 119759, the whole city standardizes 104170 management diabetics, the rate of management standardized is 86.98%, occupy the leading place in the whole country in the location. Huang Hong says, believes through the education of this project and practises the activity, can unquestionably train one batch and meet diabetic administrative staff of the community who prevented and cured the demand for Shanghai. Enlightenment Shi Yong Quan that IDF guide gives to us is said during lessons, the international diabetic alliance (IDF) The guide monitors, puts forward very good suggestion 2 type diabetic's blood glucose, this is very important for community's doctor. Then, how was IDF guide produced? Which enlighten this guide bring to the doctor's work? Enlighten one: Blood glucose is monitored not only monitors, should combine with medical treatment, sport and diet. Research reveals, blood glucose is monitored (SMBG) oneself It is the 2 type diabetic's component of managing tactics, can supervise diabetics to strengthen self- management. The diabetic and cooperation of the medical group are very important, the patient offers the effective data to the doctor, the doctor utilizes these data to instruct the patient again, form a kind of close cooperation mode. In particular, the diabetic can assess the influence that empty stomach, having a dinner, sport,etc. bring to blood glucose through SMBG tool, understand and drop the curative effect of the candy medicine, make life quality get obvious improvement. Study to reveal, paying attention to oneself's management and improved tactics of the behavior can let the diabetic's clinical terminal be obviously reduced. That is to say, the patient, instead of adding into behavior of management of blood glucose passively actively, it is of much good to prevent as to control and complication of blood glucose. Enlighten two: The diabetic should participate in control, diabetes of blood glucose and prevent and cure education. The guide proposes, only medical worker and diabetic monitor the result to analyze to blood glucose, and while changing the manner or changing the healing solution in view of the above, SMBG is to diabetic's most effective tool. IDF guide proposes proposing following clinically: First, the diabetic or medical personnel possesses certain knowledge, and would like to monitor and treat SMBG to adjust and plan with diabetic health care to combine, therapeutic goal that could reach unanimity; Second, should consider strengthen patient's understanding of group while using SMBGing while making a definite diagnosis of, help the doctor through the information at the same time, begin to treat and optimize the healing solution in time; Third, should regard SMBG as the important component of present diabetic self-education, make the patient find out about disease better, participate in controlling and treats and go in the middle disease actively and effectively. Change the manner as required, intervene medicines at the same time, and can be to medical worker's consultation; Fourth, should make individual's SMBG scheme; The fifth, the purpose should be identical when diabetic, medical personnel use as SMBG and the data, the patient should place truly on record, offer to the medical worker; Six,take the SMBG one operation method simple,can standardization. How the diabetic manages king Wei Qing and says, the final goal of diabetic treatment is to let the diabetes patient survive a bit longer, delay the emergence of complication. Diabetes and previous morbidity of diabetes increase with the difference of age gradually, the age bracket of the highest peak is 60 years old. Americans had a diabetic education system at the beginning of the seventies of the 20th century, educated patients while educating a doctor, and the task of educating the patient is to do by the complete doctor, only our community doctor. What should management of diabetic's community be in charge of? Mainly have the following several points: First, pay attention to saccharified hemoglobin ( HbA1C) . HbA1C can reflect patient's situation of blood glucose within 3 months. The guide requires HbA1C to control in 6.5~7, and there is only a minority up to standard in fact, prove the doctor's task is very arduous, the doctor should educate the patient. Community's doctor should unite with the large hospital, do according to the guide. Does Wang WeiQing say, why pay attention to HbA1C? International relevant research indicates, HbA1C drops by a percentage point each time, complication will be reduced by 40%, so HbA1C index is up to standard, indicates blood glucose is controlled very well after the meal, if HbA1C index is high, prove blood glucose of the empty stomach is not controlled well. Second, do a good job of structural monitoring. Diabetes was prevented and cured " Five carriages " (diabetic education, movement, life style are intervened, medicine, monitoring) None of them can be dispensed with. Structural blood glucose is monitored including hypoglycemia and hyperglycemia are monitored. Blood glucose monitors or relies mainly on monitoring oneself. If the patient feels uncomfortable and must check blood glucose, propose taking two all days at least one week, monitor from 7 to 9 blood glucose, three before the meal, after the meal, sleep, and the monitoring at before dawn two o'clock by three. The hypoglycemia is the important inducement of complication. Finish the intersection of patient and blood glucose control, it summarizes Zou to be large to enter, organize the intersection of community and doctor discuss to 5 case of diabetic in practice. He says: "Training 5 cases that China discusses come from practice, everybody can monitor the blood glucose situation oneself and change the standard curve that a blood glucose monitors with it through this kind, monitor patient's blood glucose situation according to this standard curve. We must go to destination according to the route, want, let HbA1C of patient up to less than 7. Hope everybody can monitor, pursue to the structural blood glucose that 20 diabetics that oneself administers last 3 months, monitor life style and healing solution of pursuing to adjust the patient according to this, finish a patient's action plan. " Chinese Medical Association diabetic branch will organize the assessment of the project, will hope each community doctor finishes controlling the summary of the result to 20 patient's blood glucose in practice, article that doctor write can ask expert evaluate, elect the whole country lower the intersection of candy and bodyguard 2012 year, will jointly award medals with the newspaper office of the health by Chinese Medical Association's diabetic credit, the outstanding article can also be published on " China's complete medical magazine ". Da Zou enter, hope the intersection of community and doctor of Shanghai can make good achievements. (staff reporter Wang LingLing puts in order)


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