Department of Internal Medicine III, University Hospital, Jena, Germany.
Patient Educ Couns. 2013 Oct;93(1):108-13. doi: 10.1016/j.pec.2013.05.008. Epub 2013 Jun 6.
Evaluation of an ambulatory diabetes teaching and treatment refresher programme (DTTP) for the optimization of intensified insulin therapy in patients with type 1 diabetes (refresher course).
85 outpatients took part in this prospective multicentre trial. Metabolic and psychosocial data were analyzed at baseline (V1), 6 weeks (V2) and 12 months after DTTP (V3).
In patients with baseline HbA1c>7% (88%), HbA1c decreased by 0.36% (p=0.004). The percentage of patients with HbA1c≤7% increased from 21.3 to 34.9% and with HbA1c above 10% decreased from 6.6 to 1.6% at V3. The incidence of hypoglycaemia decreased significantly: non severe hypoglycaemia from 3.31 to 1.39 episodes/pat/week (p=0.001) and severe hypoglycaemia from 0.16 to 0.03 episodes/pat/year (p=0.02). The treatment satisfaction increased by +10 of maximal ±18 points. The negative influence of diabetes on quality of life decreased from -1.93 to -1.69 points (p=0.031).
In a group of patients with moderately controlled diabetes type 1 who were already treated with intensified insulin therapy, metabolic control, treatment satisfaction and quality of life were improved after participation in an ambulatory DTTP without increasing insulin dosage, number of injections or insulin species.
This DTTP is effective for the optimization of intensified insulin therapy.
评估一种针对 1 型糖尿病患者强化胰岛素治疗的门诊教学和治疗进修方案（进修课程），以优化强化胰岛素治疗。
85 名门诊患者参与了这项前瞻性多中心试验。在基线（V1）、6 周（V2）和强化胰岛素治疗后 12 个月（V3）时分析代谢和心理社会数据。
在基线时 HbA1c>7%（88%）的患者中，HbA1c 降低了 0.36%（p=0.004）。HbA1c≤7%的患者比例从 21.3%增加到 34.9%，HbA1c>10%的患者比例从 6.6%降至 1.6%。低血糖的发生率显著降低：非严重低血糖从 3.31 次/患者/周降至 1.39 次/患者/周（p=0.001），严重低血糖从 0.16 次/患者/年降至 0.03 次/患者/年（p=0.02）。治疗满意度增加了+10 分（满分±18 分）。糖尿病对生活质量的负面影响从-1.93 分降至-1.69 分（p=0.031）。
在一组已经接受强化胰岛素治疗、血糖控制中等的 1 型糖尿病患者中，参加门诊强化胰岛素治疗进修课程后，在不增加胰岛素剂量、注射次数或胰岛素种类的情况下，代谢控制、治疗满意度和生活质量得到改善。
该进修课程可有效优化强化胰岛素治疗。
