2型糖尿病患者自我血糖监测现状及其影响因素  

Status and influencing factors of self-monitoring blood glucose in patients with type 2 diabetes mellitus

作　　者：郭婷婷[1] 张建双[1] 李昱芃[1] 李瑾[1] 谢云[1] 

机构地区：[1]天津医科大学代谢病医院糖尿病神经内科,天津市内分泌研究所(国家卫计委激素与发育重点实验室),天津300070

出　　处：《临床荟萃》2017年第4期317-322,共6页Clinical Focus

摘　　要：目的了解2型糖尿病(T2DM)患者自我血糖监测(self-monitoring of blood glucose,SMBG)现状,探讨影响规律SMBG的相关因素,并分析SMBG频率与血糖控制水平之间的关系。方法选取天津医科大学代谢病医院糖尿病神经内科住院的2型糖尿病患者289例,通过问卷调查的方式调查该人群的自我血糖监测情况、患者一般情况、糖尿病综合管理情况、血糖控制水平及是否合并急慢性并发症等。结果在被调查的289例患者中,平均每月自我血糖监测次数为10.03次,每月监测不少于4次的患者有55.1%。Logistic回归分析显示,饮食控制、运动治疗和糖化血红蛋白(HbA1c)是影响规律SMBG的主要因素(P<0.05)。另外,年龄、空腹血糖(FBG)、餐后2小时血糖(P2BG)、是否接受过糖尿病教育、是否进行胰岛素治疗及是否发生过低血糖也可以影响SMBG(P<0.05),SMBG与糖尿病并发症之间无明显关联(P>0.05)。SMBG频率与FBG、P2BG和HbA1c水平呈负相关(r=-0.276,-0.360,-0.361,P<0.05);口服药治疗患者与胰岛素治疗患者,当SMBG频率至少分别为7.5次/月(2次/周)、10.5次/月(3次/周)时可使血糖基本达标。结论我院2型糖尿病患者SMBG的知识水平和监测质量相对较低,医护人员可通过为患者制定个体化的血糖监测方案,并加强糖尿病相关饮食、运动知识及血糖监测知识的宣教来进一步提高。SMBG可以改善血糖控制,反之血糖水平也可影响SMBG。SMBG与糖尿病并发症的关系仍需进一步论证。Objective To investigate the status and related factors of self-monitoring blood glucose（SMBG）in patients with type 2diabetes mellitus（T2DM）,and to explore the relationship between SMBG frequency and glycemic control.Methods A total of 289T2 DM patients who hospitalized in Tianjin Metabolic Disease Hospital were enrolled in the study.A questionnaire survey was conducted on SMBG frequency,gender,age,duration,education,diabetes comprehensive management,blood glucose level,and related complications.Results Among 289 eligible patients,the average SMBG frequency was 10.03 times per month,with 55.1% patients monitored no less than 4times per month.Logistic regression analysis showed that dietary control,exercise therapy and HbA1 c level were the main factors affecting regular SMBG（P〈0.05）.In addition,age,FBG,P2 BG,whether received diabetes education,whether insulin treatment and whether presented hypoglycemia were independent effect for SMBG frequency（P〈0.05）,there was no clear association between SMBG and diabetic complications（P〈0.05）.SMBG frequency was negatively correlated with FBG,P2 BG and HbA1 c levels（r =-0.276,-0.360,-0.361,respectively;P〈0.05）;Oral hypoglycemic agents treated patients and insulin treated patients,when the SMBG frequency was at least 7.5times per month（2times/week）,10.5times per month（3times/week）,respectively,the glycemic control can basically reach the standard.Conclusion The level of knowledge and monitoring quality of SMBG in T2 DM patients were relatively low.In order to improve this situation,endocrinologists and nurses can develop individualized SMBG programs for patients,and strengthen the education on diabetes-related diet,exercise therapy and blood glucose monitoring knowledge.SMBG can improve glycemic control,while glucose levels can also affect SMBG.The relationship between SMBG and diabetic complications still needs further proof.

关 键 词：糖尿病 2型 血糖自我监测 血糖 因素分析 统计学 

分 类 号：R587.1[医药卫生—内分泌]