不同管理模式对2型糖尿病患者自我管理能力及血糖控制达标的影响

doi:10.12183/j.scjpm.2023.0412

摘要/Abstract

摘要： 目的探讨不同管理模式对2型糖尿病（T2DM）患者自我管理能力及血糖控制达标的影响。方法选取2019年10月至2022年8月在苏州市某三甲医院确诊的T2DM患者为研究对象,按随机数字表法将其分为标准组和强化组,再根据强化组意愿将其进一步分为单纯强化组和综合组。根据T2DM患者健康管理服务规范设计糖尿病标准化管理、强化管理及综合管理方案。于管理前、管理6个月后采用中文版糖尿病患者自我管理行为量表（SDSCA）和生存质量特异性量表（DSQL）评价患者自我管理能力水平和生存质量,并比较血糖控制情况。结果共纳入T2DM患者1 598例,其中标准组752例,单纯强化组524例,综合组322例。管理6个月后,3组患者空腹血糖（FBG）、餐后2 h血糖（2hPG）水平均降低,综合组FBG、2hPG水平均低于单纯强化组、标准组（均P<0.01）;标准组血糖达标率29.92%（225/752）、单纯强化组30.15%（158/524）、综合组30.75%（99/322）,差异无统计学意义（χ²=0.073,P>0.05）;3组SDSCA各维度得分及总分均升高,DSQL各维度得分及总分均降低,且综合组的得分情况均优于单纯强化组、标准组（均P<0.01）。结论对T2DM患者采用综合管理更有利于提高患者自我管理能力,对血糖达标有积极影响,从而提升其生存质量。

关键词: 2型糖尿病, 自我管理能力, 血糖, 生存质量, 管理模式

Abstract: Objective To explore the effects of different management modes on self‐management ability and blood glucose control in patients with type 2 diabetes mellitus （T2DM）. Methods Patients with T2DM diagnosed in a tertiary hospital in Suzhou from October 2019 to August 2022 were selected and divided into standard group and intensive group according to the random number table method, and then further divided into simple intensive group and comprehensive group according to the willingness of the intensive group. According to the health management service specification for T2DM patients, the standardized management, intensive management, and comprehensive management of diabetes were designed. The Chinese version of the Summary of Diabetes Self‐Care Activities （SDSCA） and the Diabetes Specific Quality of Life （DSQL） were used to evaluate the self‐management ability and quality of life of patients before and 6 months after management, and blood glucose control was compared. Results A total of 1 598 T2DM patients were included, including 752 patients in the standard group, 524 patients in the simple intensive group, and 322 patients in the comprehensive group. After 6 months of management, fasting blood glucose （FBG） and 2-hour postprandial plasma glucose （2hPG） levels in 3 groups were decreased, and FBG and 2hPG levels in comprehensive group were lower than those in simple intensive group and standard group （all P<0.01）. The compliance rate of blood glucose control in standard group was 29.92% （225/752）, simple intensive group was 30.15% （158/524）, and comprehensive group was 30.75% （99/322）, there was no statistically significant difference （χ²=0.073, P>0.05）. The scores of all dimensions and total score of SDSCA in three groups were increased, while the scores of all dimensions and total score of DSQL were decreased, and the scores of the comprehensive group were better than those of the simple intensive group and the standard group （all P<0.01）. Conclusion The comprehensive management of T2DM patients is more conducive to improving their self‐management ability and has a positive impact on blood glucose compliance, thereby improving their quality of life.

Key words: Type 2 diabetes mellitus, Self‐management ability, Blood glucose, Quality of life, Management mode

中图分类号:

R587.1

韩琦, 顾玲, 姜洁丽. 不同管理模式对2型糖尿病患者自我管理能力及血糖控制达标的影响[J]. 华南预防医学, 2023, 49(4): 412-416.

HAN Qi, GU Ling, JIANG Jieli. Effects of different management modes on self‐management ability and blood glucose control in patients with type 2 diabetes mellitus[J]. South China Journal of Preventive Medicine, 2023, 49(4): 412-416.

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