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Abstract：
Background Type 2 diabetes mellitus (T2DM) often coexists with hypertension, significantly increasing cardiovascular risks. Lifestyle modification counseling has shown promise in managing T2DM and its comorbidities. However, the optimal frequency and structure of counseling for blood pressure control remain uncertain. Our study examines the best approach for managing blood pressure in T2DM patients by comparing the outcomes of two counseling strategies: a single session and periodic counseling over time. Methodology A total of 110 diabetic patients were enrolled, with 52 patients in each group after loss to follow-up. A randomized controlled trial compared one-time counseling (control) to six months of periodic counseling (intervention) on lifestyle modification. A weighing machine, stadiometer, 24-hour dietary recall, food frequency questionnaire, biochemical blood sugar level analysis, and telephonic follow-up were the essential tools used. The data were analyzed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA), employing descriptive statistics, including frequencies, percentages, graphs, mean, and standard deviation. Statistical significance at the 5% level was tested using probability (p) calculations. The Kolmogorov-Smirnov test confirmed normal distribution (p > 0.05). Parametric tests, specifically independent t-tests, were used for between-group comparisons of continuous variables, while categorical variables were analyzed using the chi-square test or Fisher\'s exact test. Intragroup comparisons over time employed repeated-measures analysis of variance for continuous variables. Changes within groups after six months were assessed using paired t-tests. All statistical analyses adhered to a significance level of p < 0.05. Results The gender distribution at baseline was similar between the control (55.8% male, 44.2% female) and intervention (46.2% male, 53.8% female) groups, with no significant differences (p = 0.327). The mean weight was 66.67 ± 11.51 kg in the control group and 67.14 ± 11.19 kg in the intervention group (p = 0.835), and the body mass index was 25.61 ± 4.09 kg/m² and 26.29 ± 6.01 kg/m², respectively (p = 0.503). Clinical parameters such as fasting blood sugar, postprandial blood sugar, glycosylated hemoglobin, and blood pressure showed no significant differences between the control and intervention groups at baseline (p > 0.05). After six months, the intervention group exhibited a trend toward lower blood pressure compared to the control group, but the differences were not statistically significant. The mean systolic blood pressure was 132.15 ± 14.867 mmHg in the control group and 129.15 ± 9.123 mmHg in the intervention group (p = 0.218). Changes in blood pressure over the six-month period showed significant decreases within the intervention group, while changes in the control group did not reach statistical significance. The mean difference in systolic blood pressure in the intervention group was 5.54 ± 9.77 mmHg (p = 0.0001), indicating a notable reduction, while the control group had a smaller and statistically insignificant increase of 2.308 ± 9.388 mmHg (p = 0.082). Conclusions This study addresses a significant gap in the literature by comparing the efficacy of one-time vs. periodic counseling in T2DM management. While periodic counseling shows promise in improving diastolic blood pressure, further research is needed to understand its nuanced effects and optimize lifestyle interventions for T2DM patients.
摘要：
背景2型糖尿病(T2DM)常与高血压并存,显著增加心血管风险。生活方式改变咨询在管理T2DM及其合并症方面显示出希望。然而,血压控制咨询的最佳频率和结构仍不确定。我们的研究通过比较两种咨询策略的结果来检查管理T2DM患者血压的最佳方法：单次咨询和随时间的定期咨询。方法共纳入110例糖尿病患者,每组52例患者术后失访。一项随机对照试验比较了一次性咨询（对照）与六个月的定期咨询（干预）对生活方式的改变。称重机,测风仪,24小时饮食召回，食物频率问卷，生化血糖水平分析，电话跟进是使用的基本工具。使用SPSS24.0版(IBMCorp.,Armonk,NY,美国),采用描述性统计数据，包括频率,百分比,graphs,意思是，和标准偏差。使用概率(p)计算测试5%水平的统计显著性。Kolmogorov-Smirnov检验证实正态分布(p>0.05)。参数测试,特别是独立的t检验，用于连续变量的组间比较，而分类变量使用卡方检验或Fisher精确检验进行分析。随时间的组内比较采用连续变量的重复测量方差分析。使用配对t检验评估6个月后组内的变化。所有统计分析均符合P<0.05的显著性水平。结果基线时的性别分布与对照组相似(55.8%为男性,44.2%女性)和干预(46.2%男性，53.8%女性)群体，无显著性差异(p=0.327)。对照组平均体重为66.67±11.51kg,干预组为67.14±11.19kg(p=0.835),体重指数为25.61±4.09kg/m²和26.29±6.01kg/m²，分别(p=0.503)。临床参数，如空腹血糖，餐后血糖,糖化血红蛋白,对照组和干预组基线血压差异无统计学意义(p>0.05)。六个月后,与对照组相比，干预组表现出降低血压的趋势，但差异无统计学意义。对照组平均收缩压为132.15±14.867mmHg,干预组为129.15±9.123mmHg(p=0.218)。6个月期间的血压变化显示干预组内有显著下降,而对照组的变化没有达到统计学意义。干预组收缩压的平均差值为5.54±9.77mmHg(p=0.0001),表明显著减少，而对照组的增加较小，统计学上无统计学意义，为2.308±9.388mmHg（p=0.082）。结论本研究通过比较一次性与T2DM管理中的定期咨询。虽然定期咨询显示出改善舒张压的希望，需要进一步的研究来了解其细微差别效应,并优化对T2DM患者的生活方式干预.
