Effectiveness of cognitive behavior therapy for sleep disturbance and glycemic control in persons with type 2 diabetes mellitus:A community-based randomized controlled trial in China  

作　　者：Huai-Zhong Zhang Pan Zhang Gui-Qiu Chang Quan-Yong Xiang Huan Cao Jin-Yi Zhou Zong-Mei Dong Cheng Qiao Chun-Rong Xu Yu Qin Pei-An Lou 

机构地区：[1]Department of Psychiatry,Xuzhou Third People’s Hospital,Xuzhou 221000,Jiangsu Province,China [2]Department of Control and Prevention of Chronic Non-communicable Diseases,Xuzhou Center for Disease Control and Prevention,Xuzhou 221006,Jiangsu Province,China [3]Department of Control and Prevention of Chronic Noncommunicable Diseases,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,Jiangsu Province,China [4]Department of Epidemiology and Health Statistics,Xuzhou Medical University,Xuzhou 221006,Jiangsu Province,China

出　　处：《World Journal of Diabetes》2021年第3期292-305,共14页世界糖尿病杂志（英文版）（电子版）

基　　金：The Preventive Medicine Research Projects of Jiangsu Province Health Department,No.Y2015010 and No.Y2018016;The Science and Technology projects of Xuzhou city,No.KC15SM046;the Youth Medical Talent Project of“Ke Jiao Qiang Wei Projects”in Jiangsu Province,No.QNRC2016375.

摘　　要：BACKGROUND Poor sleep quality is a common clinical feature in patients with type 2 diabetes mellitus(T2DM),and often negatively related with glycemic control.Cognitive behavioral therapy(CBT)may improve sleep quality and reduce blood sugar levels in patients with T2DM.However,it is not entirely clear whether CBT delivered by general practitioners is effective for poor sleep quality in T2DM patients in community settings.AIM To test the effect of CBT delivered by general practitioners in improving sleep quality and reducing glycemic levels in patients with T2DM in community.METHODS A cluster randomized controlled trial was conducted from September 2018 to October 2019 in communities of China.Overall 1033 persons with T2DM and poor sleep quality received CBT plus usual care or usual care.Glycosylated hemoglobin A1c(HbAlc)and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were assessed.Repeated measures analysis of variance and generalized linear mixed effects models were used to estimate the intervention effects on hemoglobin A1c and sleep quality.RESULTS The CBT group had 0.64,0.50,and 0.9 lower PSQI scores than the control group at 2 mo,6 mo,and 12 mo,respectively.The CBT group showed 0.17 and 0.43 lower HbAlc values than the control group at 6 mo and 12 mo.The intervention on meanΔHbAlc values was significant at 12 mo(t=3.68,P<0.01)and that meanΔPSQI scores were closely related toΔHbAlc values(t=7.02,P<0.01).Intentionto-treat analysis for primary and secondary outcomes showed identical results with completed samples.No adverse events were reported.CONCLUSION CBT delivered by general practitioners,as an effective and practical method,could reduce glycemic levels and improve sleep quality for patients with T2DM in community.

关 键 词：Cognitive behavior therapy GLYCEMIA Sleep quality Type 2 diabetes mellitus INTERVENTION Community-based randomized controlled trial 

分 类 号：R587.2[医药卫生—内分泌] R740[医药卫生—内科学]