同伴教育联合生活方式干预对1型糖尿病患儿血糖水平胰岛素抵抗及自我管理水平的影响  

Effect of peer education combined with lifestyle intervention on blood glucose,insulin resistance and self-management in children with type 1 diabetes

作　　者：刘亚平 赵丽娜 薛晓锐 黄文贞 Liu Yaping;Zhao Lina;Xue Xiaorui;Huang Wenzhen(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China;不详)

机构地区：[1]郑州大学第一附属医院,河南郑州450000 [2]河南省人民医院,河南郑州450003

出　　处：《临床心身疾病杂志》2025年第2期48-52,87,共6页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划联合共建项目(编号LHGJ20210002)。

摘　　要：目的 探讨同伴教育联合生活方式干预对糖尿病患儿血糖水平、胰岛素抵抗及自我管理水平的影响。方法 将2021年1月~2023年12月收治的94例1型糖尿病患儿,随机分成对照组(n=47)和观察组(n=47)。对照组患儿给予常规健康教育和出院指导,观察组患儿在对照组基础上给予同伴教育联合生活方式干预。干预前后,比较两组患儿血糖水平[糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)]、胰岛素抵抗指标[空腹胰岛素水平、胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)]、自我管理水平[糖尿病管理评定量表(DCP)评分];干预后,比较两组患儿不良事件发生情况和患儿家属满意度。结果 干预后,两组患儿HbA1c、FPG、2hPG水平较干预前降低,且观察组低于对照组(P<0.01);两组患儿空腹胰岛素水平、HOMA-β较干预前升高,HOMA-IR较干预前降低,且观察组优于对照组(P<0.05或0.01);两组患儿DCP总分及各维度评分较干预前升高,且观察组高于对照组(P<0.01)。干预后,观察组患儿不良事件总发生率低于对照组(P<0.05),患儿家属总满意度高于对照组(P<0.01)。结论 同伴教育联合生活方式干预在1型糖尿病患儿中应用效果较好,值得临床推广。Objective To investigate the effect of peer education combined with lifestyle management on blood glucose,insulin resistance and self-management level of children with type 1 diabetes mellitus(T1DM).Methods Ninety-four T1DM children treated from Jan.2021 to Dec.2023 were randomly assigned to control(n=47)and observation(n=47)group.Controls received routine health education and discharge guidance and observation group did peer education plus lifestyle intervention on the basis of controls.Before and after intervention,such indexes were compared between two groups as blood glucose levels(glycated hemoglobin[HbA1c],fasting blood glucose[FPG],2-hour postprandial plasma glucose[2hPG]),insulin resistance indicators(fasting insulin level,homeostasis model assessment of insulin resistance[HOMA-IR],homeostasis model assessment ofβ-cell function[HOMA-β]),and self-management level(Diabetes Care Profile[DCP]score).After intervention,adverse events and family's satisfaction were compared between the two groups.Results After intervention,HbA1c,FPG and 2hPG levels lowered in both groups compared with pre-intervention,and those were lower in observation than control group(P<0.01);fasting insulin and HOMA-βlevels elevated,HOMA-IR lowered in both groups,the observation group was superior to controls(P<0.05 or 0.01);the total and each dimension scores of the DCP elevated in both groups and were higher in observation than control group(P<0.01).After intervention,the total incidence of adverse events was lower(P<0.05)and overall family satisfaction higher(P<0.01)in observation than control group.Conclusion Peer education combined with lifestyle interventions has a good application effect in type 1 diabetes children and is worthy of clinical promotion.

关 键 词：糖尿病 同伴教育 生活方式干预 血糖水平 胰岛素抵抗 自我管理水平 

分 类 号：R587.1[医药卫生—内分泌] R395.1[医药卫生—内科学]