Omori Keiko, Kawamura Takahiko, Urata Misako, Matsuura Mayumi, Kusama Minoru, Imamine Rui, Watarai Atsuko, Nakashima Eitaro, Umemura Toshitaka, Hotta Nigishi
Diabetic Center, Chubu Rosai Hospital, Nagoya, Japan.
Center for Preventive Medicine, Chubu Rosai Hospital, Nagoya, Japan; Department of Diabetes and Endocrine Internal Medicine, Chubu Rosai Hospital, Nagoya, Japan.
Diabetes Res Clin Pract. 2017 Aug;130:34-42. doi: 10.1016/j.diabres.2017.05.011. Epub 2017 May 12.
We investigated the effect of re-coaching on self-injection of insulin and impact of cognitive function in 100 older diabetic patients.
We examined patients on a variety of skills and knowledge regarding self-injection of insulin and evaluated the effect of re-coaching the patients after 3months and 4years. We also investigated the influence of cognitive impairment (CI) on coaching.
Skills scores for self-injection of insulin and HbA1c improved significantly 3months after re-coaching. In 51 patients followed-up for 4years, skills scores were maintained during the 4years, while knowledge scores improved after 3months but then returned to the baseline level. In the group of patients with CI as determined by the Mini-Mental Status Examination, skills scores were similar to those in the group without CI, while knowledge scores were significantly lower as compared with those in the group without CI at any time point. Skills scores were maintained during the 4years regardless of CI.
The present study showed that re-coaching in skills for self-injection of insulin was effective in improving and maintaining insulin treatment in older diabetic patients, even if patients had CI.
我们调查了重新培训对100名老年糖尿病患者胰岛素自我注射的影响以及认知功能的影响。
我们检查了患者在胰岛素自我注射方面的各种技能和知识，并评估了在3个月和4年后对患者进行重新培训的效果。我们还研究了认知障碍（CI）对培训的影响。
重新培训3个月后，胰岛素自我注射技能得分和糖化血红蛋白（HbA1c）显著改善。在51名随访4年的患者中，技能得分在4年期间得以维持，而知识得分在3个月后有所提高，但随后又回到基线水平。在通过简易精神状态检查表确定为有CI的患者组中，技能得分与无CI的患者组相似，而在任何时间点，知识得分均显著低于无CI的患者组。无论是否有CI，技能得分在4年期间均得以维持。
本研究表明，即使患者有CI，对胰岛素自我注射技能进行重新培训对改善和维持老年糖尿病患者的胰岛素治疗是有效的。
