Xiang Yingying, Luo Pingyan, Cai Xueqin, Tang Yuqin, Wu Zhongming
Key Laboratory of Hormones and Development (Ministry of Health), Tianjin Key Laboratory of Metabolic Diseases, Tianjin Metabolic Diseases Hospital & Tianjin Institute of Endocrinology, Tianjin Medical University, Tianjin, People's Republic of China.
Patient Prefer Adherence. 2017 Apr 13;11:787-793. doi: 10.2147/PPA.S130060. eCollection 2017.
The purpose of this study was to assess the efficacy and practicability of patient-to-patient (PTP) education strategy on glycemic control among patients with type 2 diabetes mellitus.
Eligible subjects from outpatient clinic were recruited and randomized to either intervention group or control group. Inpatients with poor outcomes and complications acted as mentors to share their experience with the intervention group in three tailored classes. Besides, the intervention group received general advice from specialists. The control group received general advice only. The glucose metabolic status and behavior modification indicators were evaluated before and after intervention. In addition, both groups finished a questionnaire survey regarding awareness to diabetic complications after intervention.
Eighty-four subjects were recruited (42 subjects for each group), and 51 subjects finished the study. Both the intervention group (n=29) and the control group (n=22) showed a tendency toward a decrease in glycosylated hemoglobin level (A1c, -0.8% vs -0.4%, <0.05) and improvement in behavior modification (+5.0 vs +2.8, <0.05) after 6 months. The intervention group (13.8%) obtained a higher percentage than the control group (9.1%) whose A1c reached ≤7%. The body mass index did not change significantly in any group. The questionnaire score about complication awareness was higher in the intervention group than in the control group.
This preliminary evidence suggests that PTP education strategy is acceptable for facilitating the outcome of glycemic control. Patient sense of complications may work on A1c reduction.
本研究旨在评估患者对患者(PTP)教育策略对2型糖尿病患者血糖控制的有效性和实用性。
招募门诊符合条件的受试者并随机分为干预组或对照组。结局不佳和有并发症的住院患者作为指导者,在三个量身定制的课程中与干预组分享他们的经验。此外,干预组还接受了专家的一般建议。对照组仅接受一般建议。在干预前后评估葡萄糖代谢状态和行为改变指标。此外,两组在干预后均完成了关于糖尿病并发症认知的问卷调查。
共招募了84名受试者(每组42名),51名受试者完成了研究。6个月后,干预组(n = 29)和对照组(n = 22)糖化血红蛋白水平均有下降趋势(A1c,-0.8%对-0.4%,<0.05),行为改变均有改善(+5.0对+2.8,<0.05)。干预组(占13.8%)糖化血红蛋白水平达到≤7%的比例高于对照组(占9.1%)。任何一组的体重指数均无显著变化。干预组关于并发症认知的问卷得分高于对照组。
这一初步证据表明,PTP教育策略对于促进血糖控制结果是可接受的。患者的并发症意识可能有助于降低糖化血红蛋白水平。