Exploration of a new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019_West China Medical Journal

Authors：

HUANG Jing ,  YE Wenchun , FANG Xiangming , QIAO Yan , YANG Bailin , LIU Xiaoying , QI Xiaolin

Department of Endocrinology, Mianyang Central Hospital, Mianyang, Sichuan 621000, P. R. China;

Corresponding author：

YE Wenchun, Email: ffsandy@sina.com

Keywords：

Coronavirus disease 2019; Stroke; Diabetes mellitus; Blood glucose management

DOI：

10.7507/1002-0179.202004211

Video：

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Objective To explore the application effect of the new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019.Methods A total of 120 patients with stroke and diabetes mellitus who were admitted to Mianyang Central Hospital and were consulted by the Department of Endocrinology between October 1st 2019 and April 12th 2020 were recruited. Patients who used the traditional consultation model for blood glucose management between October 1st 2019 and January 19th 2020 were classified as the control group (60 cases). Patients who were managed by the virtual ward of remote blood glucose management combined with the video consultation mode between January 20th 2020 and April 12th 2020 were classified as the observation group (60 cases). The basic conditions, the time to reach target blood glucose, the completion time of the consultation, the accuracy of blood glucose related data, the satisfaction rate of the consultation, the rate of reaching target blood glucose, the incidence of hypoglycemia, the blood glucose fluctuation (standard deviation of blood glucose level, maximum blood glucose fluctuation range), the incidence of nosocomial infections, diabetes mellitus diagnosis and treatment related expenses, and average hospitalization expenses of the two groups were compared.Results There was no significant difference in the basic conditions between the two groups of patients (P>0.05). The time to reach target blood glucose [(5.38±2.16) vs. (8.18±2.63) d], completion time ofthe consultation [(4.33±1.51) vs. (17.97±3.23) h], incidence of hypoglycemia (6.67% vs. 21.67%), standard deviation of blood glucose level [(2.16±0.34) vs. (2.52±0.34) mmol/L] and maximum blood glucose fluctuation range [(5.72±1.36) vs. (6.34±1.51) mmol/L] of the observation group were lower than those of the control group, the accuracy rate of blood glucose related data (100.00% vs. 83.33%), satisfaction rate of the consultation (93.33% vs. 73.33%) and rate of reaching target blood glucose (88.33% vs. 70.00%) of the observation group were higher than those of the control group, and the differences were statistically significant (P<0.05). There was no significant difference in the incidence of nosocomial infections, diabetes mellitus diagnosis and treatment related expenses, or average hospitalization expenses between the two groups of patients (P>0.05).Conclusion During the epidemic of coronavirus disease 2019, the combined video consultation model of remote blood glucose virtual ward for patients with stroke and diabetes mellitus has a good application effect, which has certain feasibility and clinical promotion value.

Citation： HUANG Jing, YE Wenchun, FANG Xiangming, QIAO Yan, YANG Bailin, LIU Xiaoying, QI Xiaolin. Exploration of a new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019. West China Medical Journal, 2021, 36(1): 30-34. doi: 10.7507/1002-0179.202004211 Copy

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11.	Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2015, 46(10): 3020-3035.
12.	刘兆兰, 付朝伟, 陈维清, 等. DTSQs量表在2型糖尿病患者中应用的信度、效度和反应度初步评价. 中华流行病学杂志, 2008, 29(8): 823-827.
13.	国家卫生健康委办公厅, 国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. (2020-03-04)[2020-03-16]. http://www.cac.gov.cn/2020-03/04/c_1584872634644633.htm.
14.	高姗, 李福琴. 感染防控管理质量控制策略探讨与实践. 华西医学, 2020, 35(3): 285-289.
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1. 沈洁. 基于信息化基础的新时代血糖管理模式探讨. 中华糖尿病杂志, 2019, 11(10): 695-697.
2. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet, 2020, 395(10223): 507-513.
3. Ogurtsova K, da Rocha Fernandes JD, Huang Y, et al. IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Res Clin Pract, 2017, 128: 40-50.
4. 中华医学会糖尿病学分会. 中国2型糖尿病防治指南(2017年版). 中国实用内科杂志, 2018, 38(4): 292-344.
5. 许予明, 李亚鹏, 宋波. 中国卒中高危人群筛查管理现状及对策. 中国卒中杂志, 2016, 11(1): 15-18.
6. Blecker S, Park H, Katz SD. Association of HbA1c with hospitalization and mortality among patients with heart failure and diabetes. BMC Cardiovasc Disord, 2016, 16: 99.
7. 杨小玲, 袁丽, 熊真真. 成都市某三级甲等医院非内分泌科室血糖监测管理现状分析. 护理学报, 2015(2): 1-3.
8. 李新华, 高福. 新型冠状病毒感染的肺炎公众防护指南. 北京: 人民卫生出版社, 2020: 8-9.
9. 朱仕超, 乔甫, 罗凤鸣, 等. 新型冠状病毒肺炎疫情期间四川大学华西医院援鄂医疗队驻地感染防控推荐. 华西医学, 2020, 35(3): 255-260.
10. World Health Organization. Definition, diagnosis and classification of diabetes mellitus and its complications: report ofa World Health Organization Collaborations. Diabet Med, 1999, 15(7): 539-553.
11. Powers WJ, Derdeyn CP, Biller J, et al. 2015 American Heart Association/American Stroke Association focused update of the 2013 Guidelines for the early management of patients with acute ischemic stroke regarding endovascular treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2015, 46(10): 3020-3035.
12. 刘兆兰, 付朝伟, 陈维清, 等. DTSQs量表在2型糖尿病患者中应用的信度、效度和反应度初步评价. 中华流行病学杂志, 2008, 29(8): 823-827.
13. 国家卫生健康委办公厅, 国家中医药管理局办公室. 关于印发新型冠状病毒肺炎诊疗方案(试行第七版)的通知. (2020-03-04)[2020-03-16]. http://www.cac.gov.cn/2020-03/04/c_1584872634644633.htm.
14. 高姗, 李福琴. 感染防控管理质量控制策略探讨与实践. 华西医学, 2020, 35(3): 285-289.
15. 马宇航, 彭永德. 新型冠状病毒肺炎疫情期间糖尿病管理策略思考. 上海医学, 2020, 43(3): 168-171.

West China Medical Journal

Exploration of a new in-hospital blood glucose management model for patients with stroke and diabetes mellitus during the epidemic of coronavirus disease 2019

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