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结构化血糖自我监测对接受胰岛素治疗的中国2型糖尿病患者生活质量的影响:COMPASS研究结果

Impact of structured self-monitoring of blood glucose on the quality of life of insulin-treated Chinese patients with type 2 diabetes mellitus: Results from the COMPASS study.

作者信息

Gao L, Ji L, Su Q, Feng B, Shan Z, Hu R, Xing X, Xue Y

机构信息

Peking University People's Hospital, Beijing, China.

Peking University People's Hospital, Beijing, China.

出版信息

Diabetes Res Clin Pract. 2016 Feb;112:88-93. doi: 10.1016/j.diabres.2015.08.004. Epub 2015 Sep 8.

Abstract

AIMS

To evaluate the effect of structured self-monitoring of blood glucose (SMBG) regimen on quality of life (QoL) in poorly controlled insulin-treated patients with type 2 diabetes.

METHODS

Phase II of the COMPASS trial was a 6-month, multicenter, prospective, single-arm, interventional study. This study recruited 820 outpatients from 19 clinical sites in China who met the following inclusion criteria: type 2 diabetes, insulin treatment for ≥ 3 months, and age 18-65 years, an HbA1c >8.0% (64 mmol/mol), and willingness to perform SMBG. Subjects were advised to follow a structured SMBG regimen specific to their insulin regimen, and were trained to respond to SMBG readings via lifestyle changes and insulin dose self-adjustment. QoL assessments (SF-36) were performed at baseline and 6 months.

RESULTS

Patients with a mean age of 55.13 ± 9.77 years had an average diabetes duration of 9.83 ± 7.05 years and had been receiving insulin therapy for a mean of 45.4 ± 46.79 months. All QoL parameters were significantly improved following structured SMBG after 6 months, most notably the physical role functioning (p<0.0001) and emotional role functioning (p<0.0001) component scores. Overall, 40.6% of patients rated their overall QoL as 'a bit' or a lot better' after structured SMBG compared with 16.5% prior to the intervention (p<0.0001). SMBG also improved overall feelings of wellbeing, with 39.13% of patients believing that their health was deteriorating prior to SMBG compared with only 14.4% of patients after the intervention (p<0.0001).

CONCLUSIONS

The structured SMBG program in insulin-treated Chinese outpatients with type 2 diabetes significantly improved QoL outcomes. Physical and emotional role functioning are the 2 QoL scales that demonstrate the largest improvement with SMBG.

摘要

目的

评估结构化血糖自我监测(SMBG)方案对胰岛素治疗的2型糖尿病控制不佳患者生活质量(QoL)的影响。

方法

COMPASS试验的第二阶段是一项为期6个月的多中心、前瞻性、单臂干预性研究。该研究从中国19个临床地点招募了820名门诊患者,这些患者符合以下纳入标准:2型糖尿病、胰岛素治疗≥3个月、年龄18 - 65岁、糖化血红蛋白(HbA1c)>8.0%(64 mmol/mol)且愿意进行血糖自我监测。建议受试者遵循与其胰岛素治疗方案特定的结构化血糖自我监测方案,并通过生活方式改变和胰岛素剂量自我调整来训练他们对血糖自我监测读数做出反应。在基线和6个月时进行生活质量评估(SF - 36)。

结果

平均年龄为55.13±9.77岁的患者,平均糖尿病病程为9.83±7.05年,平均接受胰岛素治疗45.4±46.79个月。6个月结构化血糖自我监测后,所有生活质量参数均有显著改善,最明显的是身体角色功能(p<0.0001)和情感角色功能(p<0.0001)分量表得分。总体而言,40.6%的患者在结构化血糖自我监测后将其总体生活质量评为“有所改善”或“改善很多”,而干预前这一比例为16.5%(p<0.0001)。血糖自我监测还改善了总体幸福感,干预前39.13%的患者认为自己的健康状况在恶化,而干预后只有14.4%的患者这样认为(p<0.0001)。

结论

胰岛素治疗的中国2型糖尿病门诊患者的结构化血糖自我监测方案显著改善了生活质量结果。身体和情感角色功能是生活质量量表中血糖自我监测改善最大的两个方面。

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