粤东地区成人1型糖尿病自我管理现状及其影响因素调查  

Current status and associated factors of self-management behaviors in adults with type 1 diabetes mellitus in the east of Guangdong China

作　　者：倪伟锋[1] 刘康成 纪文英[1] 陈立曙[1] 郑雪瑛[3] 

机构地区：[1]汕头大学医学院第二附属医院内分泌代谢科,51504l [2]南昌大学第一临床医学院 [3]中山大学附属第三医院内分泌与代谢病学科广东省糖尿病防治研究中心广东省糖尿病防治重点实验室

出　　处：《中华糖尿病杂志》2017年第11期697-701,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：中山大学5010计划项目（2007030）

摘　　要：目的了解广东省粤东地区1型糖尿病（T1DM）患者自我管理现状和相关因素。方法对汕头大学医学院第二附属医院2010年6月至2013年6月就诊成人T1DM患者使用中文版糖尿病自我管理行为量表（c-SDSCA）进行问卷调查，并收集相关临床资料，以糖化血红蛋白（HbA1c）评价血糖控制水平。对C-SDSCA量表评分与HbA1c等临床资料采用Spearman相关进行分析。结果本研究共纳入成人TIDM患者86例。平均HbA1c为9．7％±2．5％，共13例（15．1％）达标（HbA1c≤7㈣。糖尿病患者自我管理行为得分（34．9±10．6）分；50例（58．1％）患者处于中等自我管理水平，未观察到有患者处于自我管理水平优良。饮食及药物治疗自我管理行为得分最高；足部护理、血糖监测行为得分最低。相关分析显示，饮食自我管理行为与HbA1c呈负相关（r=-0．23，P=0．04）。结论粤东地区成年TIDM患者自我管理行为水平欠佳，血糖控制达标率低。目前糖尿病教育模式需优化以改善患者血糖控制。Objective To investigate the self-management behaviors in adults with type 1 diabetes mellitus （T1DM） in east of Guangdong Province and its related factors. Methods Adults with T1DM were recruited from the Second Affiliated Hospital of Shantou University Medical College from July 2010 to July 2013. The Chinese version Scale of the Diabetes Self-Care Activities （C-SDSCA） was used to assess self-care behaviors. Demographic data of clinical parameters were collected. Glycosylated hemoglobin （HbA1c, %） was used to evaluate whether or not glycemic target was achieved （HbA1c≤7%）. The relation between all dimensions of C-SDSCA and clinical parameters, such as HbA,o, were analyzed by Spearmen rank correlation analysis. Results A total of 86 adults with T1DM were enrolled in this study. The mean HbA,o level was 9.7%±2.5%. Only 15.1% （13/86） of the participants had achieved glycemic target. The total score of self-management behaviors was 34.9±10.6. Among them, 50 （58.1%） cases showed moderate level in self-management and none of them got higher level. The dimension scores of diet and medications behaviors were higher, while foot care and blood glucose monitoring were lower. The level of HbA1c and the dimension scores of diet behaviors were negatively correlated （r= - 0.23, P=0.04）. Conclusion The self-management behaviors and glycemic control in adults with T1DM in east of Guangdong province still has room to improve. Strengthening diabetes education may improve glycemic control in these group of patients.

关 键 词：糖尿病 1型 自我管理行为 血糖控制 

分 类 号：R459.5[医药卫生—治疗学]