Evaluation on the effect of comprehensive management of patients with early diabetic nephropathy in a Community

Objective To evaluate the effect of comprehensive management of patients with early diabetic nephropathy in community. Methods A randomized controlled trial was adopted and 201 patients with early diabetic nephropathy in a community were randomized into two groups:intervention group(n=101) and control group(n=100).The intervention group received comprehensive intervention and standardized management, while the control group received routine medical services of diabetes mellitus. The changes of related indicators were compared between the patients in two groups before and after twelve months of intervention. Results After twelve months of intervention, the patients in the intervention group showed greater improvement in cognition, attitude and self-management behavior for the disease compared with the patients in the control group. The values of disease-related knowledge and attitude in the intervention group increased by 1.20 points and 0.52 points significantly more than those in the control group. Medication compliance, weekly exercise time, communication between doctors and patients in the intervention group increased by 0.19 points, 0.74 times/week and 0.44 points significantly more than those in the control group(all P<0.05).Two-hour postprandial blood glucose, glycosylated hemoglobin decreased by 1.13 mmol/L and 0.42% respectively, significantly more than those in the control group. Urinary albumin/urine creatinine, systolic blood pressure decreased by 26.81 mg/g and 3 mmHg respectively, significantly more than those in the control group (all P<0.05). Conclusion Compared with the routine medical services of diabetic nephropathy, the comprehensive intervention and standardized management of early diabetic nephropathy in community is more effective on the improvement in disease-related cognition, attitude and self-management behavior, as well as the biological indexes such as urine albumin/urine creatinine, postprandial blood glucose and blood pressure.