Med Princ Pract. 2017;26(4):325-330. doi: 10.1159/000475935. Epub 2017 Apr 23.
To investigate the effect of insulin pump user retraining on treatment success, quality of life, and metabolic parameters of patients with type 1 diabetes using continuous subcutaneous insulin infusion.
A total of 35 subjects participated in this prospective study. All patients were given insulin pump user retraining. Their knowledge level and application skills, metabolic parameters, quality of life, and satisfaction from treatment were evaluated at baseline and after 6 months.
There was significant improvement in patients' knowledge and application skills after insulin pump user retraining (self-assessment of user skills: 69.7 ± 11.5 vs. 76.3 ± 11.3, p < 0.001; knowledge level on technical issues: 3.3 ± 1.1 vs. 4.1 ± 1.8, p = 0.003; glucose monitoring: 27.1 ± 5.8 vs. 29.2 ± 5.6, p = 0.006; management of hyperglycemia: 13.1 ± 3.2 vs. 15.7 ± 3.4, p < 0.001; management of pump and infusion site problems: 8.8 ± 2.6 vs. 10.6 ± 2.6, p = 0.001). Hemoglobin (Hb)A1c levels of patients with poor glycemic control improved after retraining (8.61% ± 0.78 vs. 8.23% ± 0.79, p = 0.02). However, no significant improvement in quality of life and treatment satisfaction parameters were found.
Management of type 1 diabetes in insulin pump users can be significantly improved by retraining. Even a basic short-term retraining program helps patients to increase their knowledge level and ability to more effectively use the insulin pump. The fact that retraining significantly improves glycemic parameters in patients with poor metabolic control indicates that priority should be given to this group of patients. Further studies with individualized training programs in larger sample sizes with long-term follow-up are needed to establish the importance of retraining and create re-education plans for patients with type 1 diabetes using an insulin pump.
研究胰岛素泵使用者再培训对接受持续皮下胰岛素输注治疗的 1 型糖尿病患者的治疗效果、生活质量和代谢参数的影响。
共有 35 名受试者参与了这项前瞻性研究。所有患者均接受胰岛素泵使用者再培训。在基线和 6 个月时评估他们的知识水平和应用技能、代谢参数、生活质量和治疗满意度。
胰岛素泵使用者再培训后，患者的知识和应用技能显著提高（自我评估的用户技能：69.7 ± 11.5 分比 76.3 ± 11.3 分，p < 0.001；技术问题知识水平：3.3 ± 1.1 分比 4.1 ± 1.8 分，p = 0.003；血糖监测：27.1 ± 5.8 分比 29.2 ± 5.6 分，p = 0.006；高血糖管理：13.1 ± 3.2 分比 15.7 ± 3.4 分，p < 0.001；泵和输注部位问题管理：8.8 ± 2.6 分比 10.6 ± 2.6 分，p = 0.001）。血糖控制不佳的患者在再培训后 HbA1c 水平有所改善（8.61% ± 0.78 比 8.23% ± 0.79，p = 0.02）。然而，生活质量和治疗满意度参数没有显著改善。
再培训可显著改善 1 型糖尿病胰岛素泵使用者的管理。即使是基本的短期再培训计划也有助于患者提高知识水平和更有效地使用胰岛素泵。再培训显著改善代谢控制不佳患者的血糖参数表明，应优先考虑这组患者。需要进行进一步的研究，制定个体化的培训计划，在更大的样本量和长期随访中，确定再培训的重要性，并为使用胰岛素泵的 1 型糖尿病患者制定再教育计划。
