金志萍, 顾红英, 倪小英, 于雪梅, 韩玉琴, 郭美祥. 社区2型糖尿病老年患者个体化自我管理效果评估[J]. 上海预防医学, 2018, 30(2): 120-125. DOI: 10.19428/j.cnki.sjpm.2018.18419
引用本文: 金志萍, 顾红英, 倪小英, 于雪梅, 韩玉琴, 郭美祥. 社区2型糖尿病老年患者个体化自我管理效果评估[J]. 上海预防医学, 2018, 30(2): 120-125. DOI: 10.19428/j.cnki.sjpm.2018.18419
Zhi-ping JIN, Hong-ying GU, Xiao-ying NI, Xue-mei YU, Yue-qin HAN, Mei-xiang GUO. Effect evaluation on individualized self-managemen of elderly type 2 diabetics in communities[J]. Shanghai Journal of Preventive Medicine, 2018, 30(2): 120-125. DOI: 10.19428/j.cnki.sjpm.2018.18419
Citation: Zhi-ping JIN, Hong-ying GU, Xiao-ying NI, Xue-mei YU, Yue-qin HAN, Mei-xiang GUO. Effect evaluation on individualized self-managemen of elderly type 2 diabetics in communities[J]. Shanghai Journal of Preventive Medicine, 2018, 30(2): 120-125. DOI: 10.19428/j.cnki.sjpm.2018.18419

社区2型糖尿病老年患者个体化自我管理效果评估

Effect evaluation on individualized self-managemen of elderly type 2 diabetics in communities

  • 摘要:
    目的评价个体化的自我管理对社区老年2型糖尿病患者稳定控制血糖的效果。
    方法2015年4月至2015年9月,在上海市奉贤区邬桥、西渡社区共计招募97例与家庭医生签约的门诊2型糖尿病患者纳入研究,研究对象随机分为两组,干预组49例,对照组48例。干预组:针对患者不同情况实施个体化的自我管理教育和病情评估,采用专家解疑、家庭医生服务团队上门及指导、强化家庭成员及糖友参与的综合模式; 对照组:实施常规健康教育。两组病例随访6个月,前后均进行2型糖尿病患者自我管理行为量表(DSCA)生活运动方式的调查、血糖和糖化血红蛋白的检测,低血糖的发生率等。
    结果干预组:男28例,女21例; 年龄(62.56±12.54)岁; 对照组:男27例,女22例; 年龄(62.02±11.73)岁; 两组病人在年龄、性别、文化程度、病程和治疗方法等方面差异均无统计学意义(P>0.05)。干预前,二组在饮食、运动、用药行为,血糖监测、低血糖知识认知等各项指标较对照组差异均无统计学意义(P>0.05)。干预6个月后,干预组的健康行为得分:饮食(59.92±2.38)分、运动(33.44±3.29)分、用药行为(27.30±1.46)分,血糖监测(29.22±2.85)分、低血糖知识认知(24.12±1.72)分; 血糖检测指标:空腹血糖(5.52±0.73)mmol/L、餐后2 h血糖(8.14±1.73)mmol/L及糖化血红蛋白(6.76±0.62)%,较对照组有明显改善(P<0.001)。干预6个月后,干预组健康行为得分、血糖指标的改变值均高于对照组,差异有统计学意义(P<0.001)。干预组低血糖的发生率较对照组明显下降,差异有统计学意义(P<0.001)。
    结论开展个体化的自我管理能获得更好的血糖控制,降低老年糖尿病患者低血糖的发生率。

     

    Abstract:
    ObjectiveTo evaluate the effect of individualized self-management for stable control of blood glucose among elderly diabetes patients in communities.
    MethodsFrom April to September in 2015, a total of 97 patients with type 2 diabetes signed serving contract with family physician in Wuqiao and Xidu Community health service centers of Fengxian District in Shanghai were separated randomly by Diabetes Self-care Activities(DSCA) into two groups, intervention group (n=49) and control group (n=48). Intervention group: Education of individualized self-management and disease evaluation were performed on different patients. Comprehensive mode was used in this group including disambiguation of experts, door-to-door service and guidance of family doctor team and intensified participation of family members and friends with diabetes. Control group:Regular health education was carried out.The two groups were followed up for 6 months. Before and after investigation on the life style by Diabetes Self-care Activities (DSCA) in patients with type 2 diabetes was performed, the same as detection of blood glucose and glycosylated hemoglobin, incidence of hypoglycemia etc.
    ResultsIntervention group: 28 males and 21 females with average age (62.56±12.54) years old. Control group: 27 males and 22 females with average age (62.02±11.73) years old.There were no significant differences between the two groups in age, gender, education level, course of disease and therapeutic method (P>0.05). Before intervention, there were no significant differences between the two groups in diet, exercise, drug taking behavior, blood glucose monitoring, hypoglycemia treatment and other indicators. After 6 month intervention, health behavior score of intervention group were as follows: diet (59.92±2.38) points, exercise (33.44±3.29) points, medication behavior (27.30±1.46) points, blood sugar monitoring (29.22±2.85) points, hypoglycemia treatment (24.12±1.72) points; blood glucose test:fasting plasma glucose(5.52±0.73)mmol/L, postprandial 2 h glucose (8.14±1.73)mmol/L and glycosylated hemoglobin(6.76±0.62)%, which were significantly improved comparing to the control group (P < 0.001). After 6 month intervention, the scores of healthy behaviors and blood glucose indexes of intervention group were all higher than those in control group. The difference was statistically significant (P < 0.001). Incidence of hypoglycemia in the intervention group was significantly lower than that in the control group, and the difference was statistically significant (P < 0.001).
    ConclusionDevelopment of individualized self-management can significantly obtain better glycemic control and reduce the incidence of hypoglycemia in elderly patients with diabetes.

     

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