张玉娥 周云庆 徐昱 顾潇波

摘 要 目的：评价2020年新冠肺炎疫情对社区糖尿病患者健康管理效果的影响，为更好地开展社区糖尿病患者健康管理提供依据。方法：收集截至2020年6月30日在上海市曲阳路街道社區卫生服务中心进行规范慢性病健康管理满2年的3 537例糖尿病患者的信息，平均年龄（72.13±9.82）岁，其中男性1 602例，女性1 935例。比较2020年1-6月（疫情期间）与2019年1-6月（非疫情期间）的健康管理情况，评价管理效果。结果：糖尿病患者2020年1-6月的血糖监测频率、运动时间及接受面对面随访的比例少于2019年同期，漏服药情况高于2019年同期，空腹血糖及糖化血红蛋白水平均高于2019年同期，差异具有统计学意义（P<0.05）。结论：受2020年新冠肺炎疫情影响，社区糖尿病患者的健康管理效果有所下降，造成原因主要是运动减少、血糖监测频次下降、漏服药情况增加及随访方式的变化，提示社区家庭医生在今后的社区慢病管理访视工作中，应加强面对面访视，重视健康教育的方式和干预水平，以提高健康管理的效果，有效降低新冠肺炎疫情对糖尿病患者管理效果造成的影响。

关键词 新冠肺炎；社区；糖尿病；健康管理

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2021）10-0060-03

The impact of COVID-19 epidemic on the health management of diabetes patients in the community

ZHANG Yue1， ZHOU Yunqing2*， XU Yu2， GU Xiaobo2（1.Public Health Department of Quyang Community Health Service Center of Hongkou District， Shanghai 200437， China； 2.General Practice Department of of Quyang Community Health Service Center of Hongkou District， Shanghai 200437， China）

ABSTRACT Objective： To evaluate the impact of the COVID-19 epidemic in 2020 on the health management of diabetes patients in the community， and to provide a basis for better community health management of diabetic patients. Methods： Information on 3 537 diabetic patients who had performed standardized chronic disease health management at the Quyanglu Community Health Service Center in Shanghai was collected as of June 30， 2020， with an average age of （72.13±9.82） years， among them， there were 1 602 males and 1 935 females. The health management situations from January to June 2020（during the epidemic period） and January to June 2019（during the non-epidemic period） were compared to evaluate the management effect. Results： The frequency of blood glucose monitoring， exercise time， and face-to-face follow-up of diabetic patients from January to June 2020 were less than those in the same period of 2019. The rate of missed medication was higher than that in the same period of 2019， fasting blood glucose and glycosylated hemoglobin levels were higher than those in the same period of 2019， and the difference was statistically significant（P<0.05）. Conclusion： Affected by COVID-19 epidemic in 2020， the health management effect of community diabetes patients has declined. The main causes are decreased exercise， decreased frequency of blood glucose monitoring， increased missed medication and changes in follow-up methods. It is reminded that in the future community chronic disease management visits， family doctors in the community should strengthen face-to-face visits， pay attention to health education methods and intervention levels to improve the effectiveness of health management and effectively reduce the impact of COVID-19 on the management of diabetic patients.

KEY WORDS COVID-19； community； diabetes； health management

在新型冠状病毒肺炎疫情期间，糖尿病患者作为高风险人群，其感染風险与血糖控制情况密切相关。有研究表明，糖化血红蛋白（HbA1c）每增加1%，社区获得性感染风险增加3%，医院获得性感染风险增加6%，血糖过高或过低均能不同程度地增加感染风险[1]。而糖尿病健康管理作为国家公共卫生服务的重要内容可为社区糖尿病患者提供了有力的健康保障。本文旨在分析新冠肺炎疫情对社区糖尿病健康管理效果的影响因素，为提高健康管理效果提供理论依据。

1 对象与方法

1.1 对象

以截止2020年6月30日在上海市曲阳路街道社区卫生服务中心建立糖尿病慢性病管理档案满2年，并持续进行规范随访管理的糖尿病患者为研究对象。……