社区2型糖尿病患者的自我管理行为与其血糖控制的相关性研究  

Correlation between self-management behaviors and blood glucose control in patients with type 2 diabetes mellitus in community

作　　者：于平平[1] 肖湘成[2] 王琳云[1] 王磊[1] 

机构地区：[1]中南大学湘雅医院老干科,长沙410008 [2]中南大学湘雅医院肾内科,长沙410008

出　　处：《中南大学学报（医学版）》2013年第4期425-431,共7页Journal of Central South University ：Medical Science

摘　　要：目的:调查社区2型糖尿病患者的自我管理行为水平,并探讨其与血糖控制之间的关系。方法:采用整群分层随机抽样的方法,抽取社区2型糖尿病患者211名调查其自我管理行为水平。同时现场检测研究对象的空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1C),比较不同组间血糖水平的差异,并分析患者自我管理行为与其血糖水平的关系。结果:调查对象中自我管理行为总体水平不高;2hPG,HbA1C受不同自我管理行为水平的影响较大(P<0.05);自我管理行为与FPG(r=–0.277,P=0.015),2hPG(r=–0.453,P<0.001),HbA1C(r=–0.435,P=0.001)呈负相关;病程≥5年时患者的血糖控制因自我管理行为的不同而呈现明显的不同;患者的FPG与饮食控制的管理最相关,2hPG与饮食控制、坚持用药、血糖自我监测3个管理维度密切相关,HbA1C与饮食控制、坚持用药相关;患者参加糖尿病教育的次数、使用胰岛素治疗的方式以及病程是影响社区2型糖尿病患者自我管理行为的重要因素。结论:社区2型糖尿病患者自我管理行为水平不佳,良好的自我管理行为有助于患者的血糖控制,特别是2hPG和HbA1C的控制;在提高社区2型糖尿病患者自我管理行为时要关注患者的病程、治疗的方式以及接受糖尿病健康教育的内容与效果。Objective： To investigate the self-management behaviors of patients with type 2 diabetes mellitus （DM） in a community and to explore the relationship between serf-management behaviors and the control. glycemic Methods： A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The plasma glucose （FPG）, 2 h postprandial plasma glucose （2hVG） and glycated hem level were tested. The differences between groups and relationship between fasting oglobin （HbA1C） self-management behaviors and glycemic control were analyzed. Results： Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors （P〈0.05）. The self-management behaviors were negatively related to FPG （r=-0.277, P=0.015）, 2hVG （r=-0.453, P=0.001）, and HbA1C （r=-0.435, P=0.001）. Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbAIC level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community. Conclusion. Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.

关 键 词：2型糖尿病 社区 自我管理行为 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]