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

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.