Effect of the Internet on Hierarchical Medical System for Diabetes from the Perspective of Diabetes Self-management Support

doi:10.3969/j.issn.1007-9572.2016.36.007

Abstract

Abstract: In recent years,more attention has been paid to diabetes self-management support（DSMS） globally.The role of internet-based DSMS,one of the main forms of DSMS,has significantly won increased recognition.Community-based DSMS and internet-based DSMS can be integrated to form a more efficient and feasible DSMS model.Internet-based DSMS can be a way to link hospital-based DSME and community-based DSMS and improve the hierarchical medical system as a continued service model that combines education,diagnosis,treatment,rehabilitation,nursing,and so on,all in one for diabetes in China.

Key words: Diabetes mellitus, Hierarchical medical system, Diabetes self-management support, Internet+

摘要： 糖尿病自我管理支持（DSMS）在国内外得到越来越多的重视，而基于互联网的DSMS作为DSMS的重要形式之一，其作用已得到证实。整合基于互联网的DSMS与基于社区医疗机构的DSMS可形成更加高效的DSMS模式，其能将医院DSME-社区DSMS有机链接在一起，形成一个集教育、诊断、治疗、康复、护理等于一体的连续性服务模式，进一步推动我国糖尿病分级诊疗工作。

关键词: 糖尿病, 分级医疗, 糖尿病自我管理支持, 互联网+

SUN Zi-lin, LIU Jing-bao. Effect of the Internet on Hierarchical Medical System for Diabetes from the Perspective of Diabetes Self-management Support[J]. Chinese General Practice, 2016, 19(36): 4438-4441,4446.

孙子林, 刘晶宝. 糖尿病自我管理支持视角下互联网对分级诊疗的影响和促进[J]. 中国全科医学, 2016, 19(36): 4438-4441,4446.

References

［1］National Standards for Diabetes Self-Management Education Programs.Task force to revise the national standards［J］.Diabetes Care，1995，18（1）:141-143. ［2］American Association of Diabetes Educators.Standards for outcomes measurement of diabetes self-management education［J］.Diabetes Educ,2003,29（5）:804-816. ［3］TANG T S,GILLARD M L,FUNNELL M M,et al.Developing a new generation of ongoing:Diabetes self-management support interventions:a preliminary report［J］.Diabetes Educ，2005，31（1）:91-97. ［4］FUNNELL M,BROWN T L,CHILDS B P,et al.National standards for diabetes self-management education［J］.Diabetes Care，2009，32（Suppl 1）:S87-94. ［5］International Diabetes Federation.International standards for diabetes education［EB/OL］.［2016-10-23］.http://www.idf.org/education/resources/standards. ［6］唐黎之,童南伟.2012美国糖尿病学会糖尿病医学诊治标准解读［J］.中国医学前沿杂志（电子版）,2012,4（3）:58-63. TANG L Z,TONG N W.Interpretation of the American Diabetes Association standard of medical diagnosis and treatment of diabetes in the United States 2012［J］.Chinese Journal of the Frontiers of Medical Science（Electronic Version）,2012，4（3）：58-60.DOI:10.3969/j.issn.1674-7372.2012.03.016. ［7］HAAS L,MARYNIUK M,BECK J,et al.National standards for diabetes self-management education and support［J］.Diabetes Care，2014，37 （Suppl 1）:S144-153. ［8］CHAMBERLAIN J J,RHINEHART A S，SHAEFER CF J R，et al.Diagnosis and management of diabetes:synopsis of the 2016 american diabetes association standards of medical care in diabetes［J］.Ann Intern Med，2016,164（8）:542-552. ［9］KENNEDY A,BOWER P,REEVES D,et al.Implementation of self management support for long term conditions in routine primary care settings:cluster randomised controlled trial［J］.BMJ，2013，346:f2882.DOI:10.1136/bmj.f2882. ［10］Diabetes Prevention Program（DPP） Research Group.The Diabetes Prevention Program（DPP）:description of lifestyle intervention［J］.Diabetes Care，2002，25（12）:2165-2171. ［11］国务院办公厅.国务院办公厅关于推进分级诊疗制度建设的指导意见（国办发〔2015〕70号）［EB/OL］.（2015-09-08）［2016-11-02］.http://www.gov.cn/zhengce/content/2015-09/11/content_10158.htm. General Office of the State Council.Guiding opinions of the general office of the State Council on promoting the construction of the treatment classification system（2015 No.70）［EB/OL］.（2015-09-08）［2016-11-02］.http://www.gov.cn/zhengce/content/2015-09/11/content_10158.htm. ［12］周寿祺.划区医疗服务质疑［J］.中国医院管理,1984（9）：42-44. ZHOU S Q.Questioned the zoning of medical service［J］.Chinese Hospital Management,1984（9）：42-44. ［13］医院分级管理办法（试行草案）全文［EB/OL］.（1989-11-29）［2016-11-01］.http://www.law-lib.com/law/law_view.asp?id=6146. The full text of the hospital grading management approach（draft for trial implementation）［EB/OL］.（1989-11-29）［2016-11-01］.http://www.law-lib.com/law/law_view.asp?id=6146. ［14］颜清辉.以问题为导向推进分级诊疗制度建设［J］.中国医疗保险,2015（10）:9-10,14. YAN Q H.Construction of the system of grading diagnosis and treatment based on problem oriented［J］.Medical Insurance in China,2015（10）:9-10,14.DOI:10.3969/j.issn.1674-3830.2015.10.003. ［15］国家卫生计生委关于印发2014年卫生计生工作要点的通知［J］.中国乡村医药,2014,21（4）:83-86. Notice of the National Health and Family Planning Commission on printing and distributing the key points of health and family planning work in 2014［J］.Chinese Rural Medicine,2014,21（4）:83-86. ［16］国务院办公厅关于推进分级诊疗制度建设的指导意见［J］.中国乡村医药,2015,22（20）:86-88. Guiding opinions of the General Office of the State Council on promoting the construction of the grading system of diagnosis and treatment ［J］.Chinese Rural Medicine,2015,22（20）:86-88.DOI:10.3969/j.issn.1006-5180.2015.20.045. ［17］Standards of medical care in diabetes-2014［J］.Diabetes Care，2014，37（Suppl 1）:S14-80.DOI:10.2337/dc14-S014. ［18］孙士东.浅析目前分级诊疗体系的现状［J］.中国保健营养（中旬刊）,2014，24（5）:2750-2751. SUN S D.Analysis of the current status of grading diagnosis and treatment system［J］.China Health Care & Nutrition,2014，24（5）：2750-2751. ［19］林淑周.提高基层医疗机构卫生服务能力研究综述［J］.福州党校学报,2012（1）:26-31. LIN S Z.Research on improving health service ability of primary health care institutions［J］.Journal of the Party School of Fuzhou,2012（1）：26-31.DOI:10.3969/j.issn.1674-1072.2012.01.006. ［20］何思长,赵大仁,张瑞华，等.我国分级诊疗的实施现状与思考［J］.现代医院管理,2015,13（2）:20-22. HE S Z,ZHAO D R,ZHANG R H,et al.Practical situation and consideration of classified diagnosis and treatment in China［J］.Modern Hospital Management,2015,13（2）：20-22. ［21］赵光斌，杜光会，林敏.制约双向转诊制度实施因素研究［J］.中国全科医学，2013,16（9）：2930-2932. ZHAO G B,DU G H,LIN M.Impacting factors to implementation of the two-way referral system［J］.Chinese General Practice,2013,16（9）：2930-2932. ［22］赵琨,肖月.加快实施分级诊疗工作的政策建议［J］.中华医院管理杂志,2015,31（9）:651-653 ZHAO K,XIAO Y.Policy recommendations on accelerating coordinated care delivery［J］.Chinese Journal of Hospital Administration，2015,31（9）:651-653. ［23］刘波，张剑敏，王博，等.社区2型糖尿病自我管理三位一体模式探究［J］.中国全科医学，2015，18（33）：4034-4038. LIU B，ZHANG J M,WANG B,et al.Investigation of trinity self-management mode of patients with type 2 diabetes in community［J］.Chinese General Practice，2015，18（33）：4034-4038. ［24］TRICCO A C,IVERS N M,GRIMSHAW J M,et al.Effectiveness of quality improvement strategies on the management of diabetes:a systematic review and meta-analysis［J］.Lancet，2012，379（9833）:2252-2261. ［25］KIM Y,CHEN A H,KEITH E，et al.Not perfect,but better:primary care providers’ experiences with electronic referrals in a safety net health system［J］.J Gen Intern Med，2009，24（5）:614-619. ［26］CASEBEER L,BROWN J,ROEPKE N，et al.Evidence-based choices of physicians:a comparative analysis of physicians participating in Internet CME and non-participants［J］.BMC Med Educ，2010，10:42.DOI:10.1186/1472-6920-10-42. ［27］PEREIRA K,PHILLIPS B,JOHNSON C，et al.Internet delivered diabetes self-management education:a review［J］.Diabetes Technol Ther，2015，17（1）:55-63.

[1]	HUANG Ying, ZHOU Zhiyuan, PAN Zhixiong, ZHU Qun. Advances in the Association between Metabolic Dysfunction-associated Steatotic Liver Disease, Type 2 Diabetes Mellitus and Cardiovascular Complications [J]. Chinese General Practice, 2026, 29(09): 1212-1216.
[2]	LI Jixin, QIU Linjie, REN Yan, WANG Wenru, LI Meijie, LI Wenjie, ZOU Chacha, WU Zijing, ZHANG Jin. Predictive Value of Muscle-to-Fat Ratio in Type 2 Diabetes Mellitus among Non-overweight/Obese People [J]. Chinese General Practice, 2026, 29(06): 726-732.
[3]	LI Jie, YANG Xinhui, CAO Li, ZHANG Jing, JIANG Yue. Case Analysis of General Practice Diagnosis and Treatment in a "Three High" Patient with Coexistence and Fatty Liver Disease [J]. Chinese General Practice, 2026, 29(06): 810-816.
[4]	LI Jie, JIANG Yue, CHEN Yihan. The CAPDCA Model of Personalized Patient Education Applied to an Elderly Diabetic Patient with Blood Glucose Fluctuation [J]. Chinese General Practice, 2026, 29(04): 538-544.
[5]	ZHAO Ya, WAN Qin. Relationship between Tryptase and Type 2 Diabetes Mellitus with Macrovascular Complications: a Ten-year Follow-up Study [J]. Chinese General Practice, 2026, 29(04): 476-482.
[6]	Psychosomatic Endocrinology Coordination Group of the Psychosomatic Medicine Society of the Chinese Medical Association, Diabetes Prevention and Control Committee of Chinese Preventive Medicine Association. Chinese Expert Consensus on the Diagnosis and Treatment of Diabetes Comorbid with Depression [J]. Chinese General Practice, 2026, 29(03): 273-292.
[7]	MA Yuping, QIAO Mengyuan, HE Yanyun, XU Manru, CHEN Chongli, WU Wenbin. Study on the Current Status and Influencing Factors of Mild Cognitive Impairment in Elderly Patients with Type 2 Diabetes Mellitus from the Perspective of "Physical Disease-related Adjustable Constitution": a Case Study in Sichuan Province [J]. Chinese General Practice, 2026, 29(02): 188-194.
[8]	LUO Jiaoling, ZHANG Weisen, CHAI Zhihao, ZHU Feng, ZHU Tong, JIN Yali, PAN Jing, JIANG Chaoqiang. The Association of Age at Menopause with Fasting Glucose and Diabetes [J]. Chinese General Practice, 2026, 29(02): 195-200.
[9]	ZHAO Xiaoxiao, DING Yunhan, CHEN Jiahui, WANG Haibo, KE Lixin, WANG Ziyi, GAO Wulin, LU Xiaohui, WU Jibiao, LU Cuncun. Analysis and Future Trend Prediction of Disease Burden of Elderly Type 1 Diabetes Mellitus in China and Globally from 1990 to 2021 [J]. Chinese General Practice, 2026, 29(01): 67-75.
[10]	YUAN Beibei. Defining Preventive Health Services and Exploring Implementation Strategies under the Integrated Care Model: Taking Type 2 Diabetes Care As an Example [J]. Chinese General Practice, 2026, 29(01): 100-107.
[11]	ZENG Minghui, KUAI Wentao, CHEN Lin, HAN Jiaxin, XU Lianxin, GE Liying, DAI Rongrong, MI Yuqiang, XU Liang. Effect of Type 2 Diabetes Mellitus on the Efficacy of Nucleoside (Acid) Analogues in the Treatment of Chronic Hepatitis B [J]. Chinese General Practice, 2025, 28(35): 4414-4420.
[12]	XU Jun, ZHANG Jie. The Correlation between Heart Rate Variability and Cerebral Infarction in Patients with Type 2 Diabetes Mellitus [J]. Chinese General Practice, 2025, 28(35): 4409-4413.
[13]	WANG Lizhu, LI Sihan, WANG Xinyi, MAO Sunxi, QIU Yang, WANG Zhonghua. Pathway Analysis of the Impact of Diabetes Knowledge and Self-efficacy on Self-management and Quality of Survival among Rural Patients with Type 2 Diabetes Mellitus Based on ITHBC Modeling [J]. Chinese General Practice, 2025, 28(34): 4351-4358.
[14]	WANG Mengqi, LIANG Moxuan, LI Zeyuan, GUO Yuting, CHENG Jingmin. Effectiveness of Intermittent Fasting in Patients with Type 2 Diabetes Mellitus: a Scoping Review [J]. Chinese General Practice, 2025, 28(33): 4234-4240.
[15]	LI Shunan, ZHANG Shiyan, DENG Yanan, HU Danqing, ZHENG Yuxin, LI Danyang, LI Candong. An Analysis of Trends and Prediction of Disease Burden for Type 2 Diabetic Nephropathy from 1990 to 2021 in China [J]. Chinese General Practice, 2025, 28(33): 4214-4226.