自我血糖监测对伴抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者降糖治疗的影响  

Effects of self- monitoring of blood glucose on antidiabetic treatment in non- insulin- treated type 2 diabetes mellitus patients with depression or anxiety

作　　者：欧阳海春[1] 麦思资 吴沃栋[2] 胡允兆[1] 吴焱贤[1] 黎文生[1] 陈玉映[1] 

机构地区：[1]广东省佛山市顺德第一人民医院心血管内科,528300 [2]广东省佛山市顺德第一人民医院心理科,528300

出　　处：《广东医学》2015年第17期2676-2679,共4页Guangdong Medical Journal

基　　金：广东省科技计划项目(编号:2013B021800116);广东省佛山市医学类科学攻关项目(编号:201208215)

摘　　要：目的探讨自我血糖监测对伴抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者降糖治疗的影响,以评估自我血糖监测是否适用于伴抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者。方法选取796例同一社区非胰岛素治疗的2型糖尿病患者,予以抑郁自评量表和焦虑自评量表自评,根据自评得分分为轻度抑郁、中重度抑郁、轻度焦虑、中重度焦虑、无情绪障碍,并根据血糖监测方式将每种情绪状态的患者分为自我血糖监测组和静脉血浆血糖监测组,随访16周。比较应用不同血糖监测方式的各组患者自行调整测血糖次数、自行调整降糖药物的比例及研究末糖化血红蛋白达标情况。结果伴中重度抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者,自我血糖监测组自行调整测血糖次数的比例、自行调整降糖药物的比例明显高于静脉血浆血糖监测组(P<0.05),自我血糖监测组的研究末糖化血红蛋白达标率明显低于静脉血浆血糖监测组(P<0.05)。结论伴中重度抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者使用自我血糖监测可因抑郁、焦虑情绪因素自行改变血糖监测和降糖治疗方案,影响患者的血糖达标,因此不适宜进行自我血糖监测。Objective To study the effects of self- monitoring of blood glucose（ SMBG） on antidiabetic treatment in non- insulin treated type 2 diabetes mellitus patients with depression or anxiety and evaluate whether SMBG is applicable in type 2 diabetes mellitus patients with depression or anxiety. Methods A total of 796 cases of non- insulin treated type 2 diabetes mellitus patients from the same community medical center were enrolled. All subjects completed surveys with self- rating depression scale（ SDS） and self- rating anxiety scale（ SAS）. Patients were classified as mild depression,moderate to severe depression,and / or mild depression,moderate to severe anxiety,or no emotional disorder（ ED） based on SDS and SAS scores. According to blood glucose monitoring methods,patients within each emotional status were randomly divided into SMBG group and venous plasma glucose monitoring（ VPG） group. Patients were followed up for 16 weeks. The following outcomes were compared,frequency of self- adjustment of blood glucose measurement,percentage of patients with self- adjustment of antidiabetic drugs and percentage of patients reaching clinical Hb A1 c target. Results In the moderate to severe depression or anxiety patients of the SMBG group,frequency of self- adjustment of blood glucose measurement and percentage of patients with self- adjustment of antidiabetic drugs were significantly higher than in the VPG group（ P 0. 05）. At the end of the investigation,the percentage of patients reaching clinical Hb A1 c target in the SMBG group was lower than in the VPG group（ P 0. 05）. Conclusion SMBG is not applicable in non- insulin treated type 2 diabetes mellitus patients with moderate to severe depression or anxiety. These patients may alter blood glucose monitoring and antidiabetic treatment regimen without medical consults due to emotional factors of depression or anxiety,which plays a negative role in reaching target blood glucose.

关 键 词：2型糖尿病 抑郁 焦虑 自我血糖监测 静脉血浆血糖监测 

分 类 号：R446.112[医药卫生—诊断学]