关键词: 糖尿病, 2型；糖尿病视网膜病变；糖尿病肾病；健康管理

Abstract: Objective　To study the effect of a 9-year intensive diabetes management conducted by Beijing Sanlitun Community Health Center on the incidence rate of diabetic microvascular complications （DMCs） in patients with type 2 diabetes mellitus （T2DM） and to explore the relationship of meeting the control targets of fasting plasma glucose （FPG），blood pressure and blood lipids for 3 times or more with the incidence rate of DMCs in this population.Methods　The participants were 224 T2DM patients enrolled from Sanlitun Community in 2008.They were randomized into the intensive management group （n=113） and standard management group （n=111），receiving intensive management and follow-up，standard management and follow-up，respectively，for consecutive 9 years.Comparisons were made between two groups in terms of systolic blood pressure （SBP），diastolic blood pressure （DBP），glycosylated hemoglobin （HbA1c） and low-density lipoprotein cholesterol （LDL-C） at baseline and at the end of management，and in regard to outcome events （diabetic retinopathy and diabetic nephropathy）．To investigate the relationship of management method and meeting the control targets of FPG，blood pressure and blood lipids for 3 times or more with the incidence of DMCs.Results　There were no significant differences in the distribution of sex，age，duration of T2DM，BMI，prevalence of smoking，mean SBP，DBP，FPG，2 h PG，LDL-C ，HbA1c and urinary albumin excretion rate （UAER） at baseline between the two groups （P>0.05）．At the end of management，mean FPG，2 h PG，HbA1c，LDL-C and UAER were much lower in the intensive management group （P<0.05） except the distribution of BMI，mean SBP and DBP were still similar in both groups （P>0.05）；the intensive management group showed lower incidence and exacerbation rates of diabetic retinopathy 〔0.9%（1/113） vs 5.4%（6/111）〕 and lower incidence and exacerbation rates of diabetic nephropathy 〔4.4%（5/113） vs 11.7%（13/111）〕（P<0.05）．A much lower rate of DMCs was found in those meeting the target objective for HbA1c as well as those meeting the control targets of FPG，blood pressure and blood lipids for 3 times or more in both groups（P<0.05）．Conclusion　The incidence rate of DMCs in T2DM patients can be effectively reduced by community-based intensive diabetes management.Moreover，it will be lower and improved quality of life will be achieved if the HbA1c reaching the target objective or FPG，blood pressure and blood lipids meeting the control targets for 3 times or more.

Key words: Diabetes mellitus, type 2；Diabetic retinophy；Diabetic nephropathy；Health management