As the rapid growth of the world economy and people’s living standards, the dietary structure is changing greatly day by day, and factors such as faster and faster pace of life and lack of exercise have increased the incidence and prevalence of diabetes (1). Diabetes is a public health issue of general concern around the world. It is a lifelong chronic disease that can affect multiple organs; it is the third most common, frequently-occurring, and chronic non-communicable disease after cerebrovascular disease and tumors; and it poses a serious threat to human health (2). Statistics show that there are about 347 million patients suffering from diabetes mellitus type 2 (T2DM) in the world so far, and its prevalence in low-income countries is more serious (3). Statistics from the Chinese Medical Association (CMA) Diabetes Association in 2007 showed that the prevalence of the disease in men and women over 20 years old in China is 10.6% and 8.8%, respectively, and the total prevalence is 9.7%. Based on this estimate, the total number of diabetic patients in China is currently around 92.4 million, and there are 14.82 million patients in the pre-diabetes stage (fasting plasma glucose (FPG) > 6.1 mmol/L, or 2-hour postprandial glucose (2h PG) > 7.8 mmol/L, but they have not yet reached the diagnosis criteria of diabetes). It accounts for nearly 10% and 15% of the total population, which is 4 times the statistical data in 1994 and twice the statistical data in 2001 (4, 5).

T2DM is an endocrine disease, which is very common clinically. It is characterized by high blood sugar, and it is closely related to factors such as weight (obesity) and genetics. In addition, the clinical manifestations are relatively mild at the initial stage of the illness. After the disease worsens, the symptoms of polydipsia, polyphagia, polyuria, and weight loss will occur, which greatly affect the patient’s quality of life (6). Nowadays, evidence-based medicine and clinical studies have shown that prevalence of hypertension in T2DM patients is much greater than that of those without diabetes. In clinical hypertension, it is a very common complication of diabetic patients (7). A report from World Health Organization (WHO) showed that the prevalence of concurrent hypertension in diabetic patients is 20 - 40%, which is about 40 - 50% in China. A surgery from National Health and Nutrition Examination Survey III (NHANES III) found that 71% of 1500 diabetic patients have hypertension at the same time, and the incidence of concurrent hypertension in diabetic patients is 1.5 - 3.0 times that of patients without diabetes. On the contrary, hypertension patients are more likely to develop diabetes than patients with normal blood pressure, and the incidence of diabetes is 2.0 - 2.5 times that of the normal blood pressure group (8, 9). Through epidemiological investigations, it is found that nearly 40% of T2DM patients will have hypertension, and 5% - 10% of primary hypertension may suffer from T2DM (10). These data suggest that T2DM is inseparable from hypertension. The prevention and treatment of diabetes complicated by hypertension has to be solved urgently, so as to improve people’s quality of life and health.

Incidence of hypertension in T2DM patients is increasing, and the patient’s condition will become worse when comorbidities occur. If the symptomatic treatment is not timely, it will cause anxiety and depression symptoms of the patient, and cause damage to the eyes, nerves, heart, and other parts of the patient. What is more, serious comorbidities such as kidney failure, myocardium, and cerebral infarction will occur (11, 12). At the same time, the symptoms of anxiety and depression will in turn affect the patient’s blood sugar and blood pressure control, making the symptoms of anxiety and depression more serious, and then forming a vicious circle. T2DM patients with hypertension have a very obvious curative effect in terms of drug treatment. However, symptoms such as anxiety and depression will seriously affect the occurrence and development of the disease (13).

In the past few years, the general nursing mode such as monitoring the patient’s blood sugar and blood pressure has been mostly used. However, because most diabetic patients are accompanied by hypertension and are prone to some cardiovascular and cerebrovascular diseases, this nursing mode is not effective. Therefore, while actively treating patients, it is particularly important to use a scientific nursing model. The INHE, through scientific guidance on patients’ lifestyle and medication habits, improves the quality of life of patients. For example, it can correct the bad habits of the patient’s diet and ensure a balanced intake of nutrients, so as to effectively control the weight gain, so that the incidence of diabetes is greatly reduced. It can guide patients to carry out reasonable and effective aerobic exercise, help expand the peripheral blood vessels of the body, and reduce peripheral resistance, thereby reducing the occurrence and development of hypertension. There are relatively many clinical studies on the individualized care model or health education for patients with diabetes and hypertension, but relatively few studies on the combination of the two methods (14, 15). Therefore, it explored the clinical effect of the combination of INHE on patients with T2DM and hypertension in this work.

T2DM is a chronic disease caused by insufficient insulin secretion by pancreatic β-cells or caused by insensitivity of target cells to insulin. Its course is longer, the condition is more complicated, and there are many complications, the prognosis is poor, and it is easy to relapse (16). One of the very common complications of T2DM is hypertension, which is prone to cause cardiovascular and cerebrovascular diseases. The mortality and disability rate are relatively high. It is one of the important causes of death in diabetic patients and seriously threatens the patient’s life safety (17). Some scholars believe that the cause of hypertension associated with T2DM is that the increase in blood sugar inhibits the relaxation of vascular endothelium, stimulates the transcription of vascular smooth factor genes, and leads to the emergence of hypertension. In addition, the main risk factors for increased mortality from cardiovascular and cerebrovascular diseases are hypertension, hyperglycemia, and lipid metabolism disorders (18, 19). Therefore, increasing the regulation of blood sugar and blood pressure in patients with T2DM accompanied by hypertension is of high significance for the prevention of cardiovascular and cerebrovascular diseases.

At present, methods such as reducing blood sugar and blood lipids, adjusting body weight, and changing lifestyles are commonly used clinical methods to treat T2DM with hypertension. However, most patients have symptoms such as anxiety and depression due to long treatment time and repeated illnesses, resulting in poor control of blood sugar and blood pressure levels, resulting in a low treatment rate (20). Therefore, while actively treating patients, it is particularly important to carry out a scientific and reasonable nursing model. The implementation of individualized health education combined with a nursing model can enhance the patient’s enthusiasm for cooperating with treatment, eliminate bad emotions such as anxiety and depression, and effectively improve the patient’s quality of life.

After INHE, the levels of FPG, 2h PG, SBP, and DBP, and the scores of SDS and SAS in the two groups were decreased, and those in group B were significantly lower than those in group A (P < 0.05). The DKM and rehabilitation effect of patients in group B were significantly higher than those in group A (P < 0.05); and the TER of patients in group B was 91.18%, which was higher than 76.47% in group A (P < 0.05). It can be found that INHE can effectively improve the clinical treatment effect of patients, and has very good professionalism, pertinence, and effectiveness. In this work, the psychological and physiological characteristics of patients are combined for health education for them, which strengthened the patients’ awareness of the disease and better cooperates with clinical treatment. Combined with the individualized care model, effective psychological counseling is provided to patients, to eliminate negative emotions, and to promote patients’ mastery of the use of various commonly used drugs. Thereby, it can effectively prevent abnormal blood pressure and blood sugar of patients and improve the quality of life of patients.

INHE was implemented for patients with T2DM complicated with hypertension to observe and compare DKM and rehabilitation effect of patients in the group B and the group A of patients. It was found that INHE can effectively improve the psychological cognition of patients with T2DM by hypertension, strengthen the control of blood pressure and blood sugar, and improve their quality of life. The innovation of this work lied in the combination of individualized nursing intervention and health education, which was more conducive to the rehabilitation of patients with diabetes and hypertension. However, the sample size was small, and it needed to further expand the research in the future, aiming to use more clinical experiments to verify the conclusion.

The original contributions presented in the study are included in the article/supplementary material. Further inquiries can be directed to the corresponding author.

Ethical review and approval were not required for the study on human participants in accordance with the local legislation and institutional requirements. The patients/participants provided their written informed consent to participate in this study.

RL: conceptualization, data collection and analysis, and writing–original draft. WX: data collection and wrting–original draft. PY: visualization and data collection. LT: software and visualization. ZL: writing–editing and reviewing. XG: writing–editing and reviewing, and project administration. All authors contributed to the article and approved the submitted version.

Scientific research funding program of the Second Affiliated Hospital of Chongqing Medical University (2021-13).

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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