Objective: To explore the effect of LEARNS health education on metabolic indicators, enthusiasm and related problems in patients with type 2 diabetes. Methods: A total of 118 patients with type 2 diabetes were randomly divided into the observation group (60 cases) and the control group(58 cases). The observation group adopted the LEARNS health education model intervention, while the control group adopted routine health education. The metabolic indicators(glycosylated hemoglobin, fasting blood glucose, triglyceride and total cholesterol), patients’ enthusiasm and diabetes related problems were compared between the two groups before and after intervention. Results: After the intervention, the metabolic indicators of the patients in the observation group were superior to those in the control group, the scores of enthusiasm were higher than those in the control group, and the scores of diabetes related problems were lower than those in the control group, with a statistically significant difference( P<0.05). Conclusion:LEARNS health education model can improve the metabolic indicators of patients with type 2 diabetes, improve the enthusiasm of patients, reduce diabetes related problems, and alleviate the pressure and bad mood of patients with type 2 diabetes. 

Objective: To explore the mediating role of patient activation between family functioning and health promotion self-care in patients with diabetic foot. Methods: A total of 223 diabetic foot patients were investigated with a  self-designed general information questionnaire, patients with diabetes self-care health promotion scale, scale in patients with activation and family functioning scale.Results: The total score for health promotion self-care in patients with diabetic foot was 90.72±15.51, which was at a medium level. Among them, the score of exerise was the lowest, while the score of the treatment of compliance with the doctor’s advice was the highest.The total score of activation in patients with diabetic foot was 56.37±13.83, which was at the third level.The item average score of activation function in patients with diabetic foot was 2.24±0.37, which was at a medium level. The family function was negatively correlated with health promotion self-care and patient activation, meanwhile patient activation was positively correlated with health promotion self-care（P<0.05）.Patient activation played a mediating role in the relationship between family function and health promotion self-care and the mediating effect accounted for 32.47% of the total effect. Conclusion: The clinical nurses need to pay attention to patient’s own initiative and involvement in the treatment to enhance family members’ support and emotional tolerance. Strengthening the family’s treatment initiative will benefit driving patients’ positive treatment attitude and improving their self-care ability.

Objective: To observe the effect of passive smoking during pregnancy on patients with gestational diabetes mellitus. Methods: The data of 177 patients who continued to participate in "one day outpatient service of gestational diabetes mellitus" was collected. According to whether passive smoking during pregnancy was divided into passive smoking group and non-passive smoking group, two groups of patients received the same " one day clinic for gestational diabetes " interventions. The fasting blood-glucose（FPG）,2 hours postprandial blood glucose（2hPG）, glycated hemoglobin (HbAlc), maternal outcomes and infant condition were analyzed. Results: The passive smoking rate during pregnancy among women with gestational diabetes mellitus was 45.20%. There was no significant difference in FPG、2hPG、HbAlc in the two groups before interventions ( P>0.05), but there was difference after 2 months of interventions（ P<0.05）. There was no significant difference in delivery weeks, polyhydramnios, oligohydramnios, postpartum hemorrhage and preeclampsia between two groups ( P>0.05), and there was statistical significance difference in delivery route and pregnancy-induced hypertension( P<0.05),There was no significant difference in rate of neonatal gender, length, 5-minute Apger score, hypoglycemia, malformation, hypocalcemia and asphyxia between two groups( P>0.05),and there was a statistically significant difference in neonatal body mass and rate of macrosomia ( P<0.05). Conclusion: Passive Smoking during pregnancy is one of the risk factors affecting blood glucose control in patients with gestational diabetes mellitus, smoke environmental exposure is not conducive to disease control, and it is easy to lead to adverse maternal and child outcomes.