Yu Pingping, Xiao Xiangcheng, Wang Linyun, Wang Lei
Department of Geriatrics, Central South University, Changsha, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2013 Apr;38(4):425-31. doi: 10.3969/j.issn.1672-7347.2013.04.015.
To investigate the self-management behaviors of patients with type 2 diabetes mellitus (DM) in a community and to explore the relationship between self-management behaviors and the glycemic control.
A total of 211 type 2 DM patients in a community were selected by stratified random sampling. Patients were grouped according to the scores of self-management behaviors. The fasting plasma glucose (FPG), 2 h postprandial plasma glucose (2hPG) and glycated hemoglobin (HbA1C) level were tested. The differences between groups and relationship between self-management behaviors and glycemic control were analyzed.
Self-management behaviors of most patients were not effective, and 2hPG and HbA1C were affected by different levels of the self-management behaviors (P<0.05). The self-management behaviors were negatively related to FPG (r=-0.277, P=0.015), 2hPG (r=-0.453, P=0.001), and HbA1C (r=-0.435, P=0.001). Glycemic control of the patients whose course of disease was over 5 years was significantly different due to different self-management behaviors. FPG level of the patients was positively related to alimentary control. The 2hPG level of the patients was positively related to alimentary control, medication persistence, and blood glucose self-monitoring. The HbA1C level of the patients was positively related to alimentary control and medication persistence. The times the patients received DM education, the way to use insulin, and the disease course of the patients were important factors to affect self-management behaviors of type 2 DM in the community.
Self-management behaviors of type 2 DM patients in the community are not effective. Satisfactory self-management behaviors, specially the control of 2hPG and HbA1C are beneficial to glycemic control. We can improve the self-management behaviors in type 2 DM patients by paying attention to the disease course, the treatment method, and the contents and effect of DM education.
调查社区2型糖尿病患者的自我管理行为，并探讨自我管理行为与血糖控制之间的关系。
采用分层随机抽样法选取某社区211例2型糖尿病患者。根据自我管理行为得分对患者进行分组。检测空腹血糖（FPG）、餐后2小时血糖（2hPG）和糖化血红蛋白（HbA1C）水平。分析组间差异以及自我管理行为与血糖控制之间的关系。
大多数患者的自我管理行为效果不佳，2hPG和HbA1C受不同水平自我管理行为的影响（P<0.05）。自我管理行为与FPG（r=-0.277，P=0.015）、2hPG（r=-0.453，P=0.001）和HbA1C（r=-0.435，P=0.001）呈负相关。病程超过5年的患者，由于自我管理行为不同，血糖控制存在显著差异。患者的FPG水平与饮食控制呈正相关。患者的2hPG水平与饮食控制、用药依从性和血糖自我监测呈正相关。患者的HbA1C水平与饮食控制和用药依从性呈正相关。患者接受糖尿病教育的次数、胰岛素使用方式以及病程是影响社区2型糖尿病患者自我管理行为的重要因素。
社区2型糖尿病患者的自我管理行为效果不佳。良好的自我管理行为，特别是对2hPG和HbA1C的控制，有利于血糖控制。我们可以通过关注病程、治疗方法以及糖尿病教育的内容和效果来改善2型糖尿病患者的自我管理行为。
