Sigurdardottir Arun K, Jonsdottir Helga, Benediktsson Rafn
University of Akureyri, 600 Akureyri, Iceland.
Patient Educ Couns. 2007 Jul;67(1-2):21-31. doi: 10.1016/j.pec.2007.03.007. Epub 2007 Apr 8.
To analyze which factors contribute to improvement in glycemic control in educational interventions in type 2 diabetes reported in randomized controlled trials (RCT) published in 2001-2005.
Papers were extracted from Medline and Scopus using educational intervention and adults with type 2 diabetes as keywords. Inclusion criteria were RCT design. Data were analyzed with a data-mining program.
Of 464 titles extracted, 21 articles reporting 18 studies met the inclusion criteria. Data mining showed that for initial glycosylated hemoglobin (HbA1c) level < or = 7.9% the diabetes education intervention achieved a small change in HbA1c level, or from +0.1 to -0.7%. For initial HbA1c > or = 8.0%, a significant drop in HbA1c level of 0.8-2.5% was found. Data mining indicated that duration, educational content and intensity of education did not predict changes in HbA1c levels.
Initial HbA1c level is the single most important factor affecting improvements in glycemic control in response to patient education. Data mining is an appropriate and sufficiently sensitive method to analyze outcomes of educational interventions. Diversity in conceptualization of interventions and diversity of instruments used for outcome measurements could have hampered actual discovery of effective educational practices.
Participation in educational interventions generally seems to benefit people with type 2 diabetes. Use of standardized instruments is encouraged as it gives better opportunities to identify conclusive results with consequent development of clinical guidelines.
分析2001年至2005年发表的随机对照试验（RCT）中报道的2型糖尿病教育干预措施中，哪些因素有助于改善血糖控制。
以教育干预和2型糖尿病成人为关键词，从Medline和Scopus数据库中提取论文。纳入标准为RCT设计。使用数据挖掘程序对数据进行分析。
在提取的464篇标题中，21篇报道了18项研究的文章符合纳入标准。数据挖掘显示，对于初始糖化血红蛋白（HbA1c）水平≤7.9%的患者，糖尿病教育干预使HbA1c水平有小幅变化，变化范围为+0.1%至 -0.7%。对于初始HbA1c≥8.0%的患者，HbA1c水平显著下降0.8 - 2.5%。数据挖掘表明，教育的持续时间、教育内容和强度并不能预测HbA1c水平的变化。
初始HbA1c水平是影响患者教育后血糖控制改善的最重要单一因素。数据挖掘是分析教育干预结果的一种合适且足够灵敏的方法。干预概念化的多样性和用于结果测量的工具的多样性可能阻碍了有效教育实践的实际发现。
参与教育干预通常似乎对2型糖尿病患者有益。鼓励使用标准化工具，因为这为确定确定性结果提供了更好的机会，从而有助于制定临床指南。
