State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.
Key Laboratory of Health Technology Assessment of Fujian Province University, School of Public Health, Xiamen University, Xiamen, China.
J Diabetes. 2018 Sep;10(9):715-723. doi: 10.1111/1753-0407.12651. Epub 2018 Mar 25.
This study examined the combined effects of self-monitoring of blood glucose (SMBG) and educational attainment on glycemic control in type 2 diabetes mellitus (T2DM) patients.
A cross-sectional survey was performed among community residents with T2DM. Good glycemic control was defined as HbA1c <7% in the most recent measurement. Multivariable logistic regression was used to examine associations of glycemic control with SMBG, educational attainment, and their combined effects by controlling for certain covariates, with further stratification by sex.
Complete data were available for 798 patients, of which 58.52% had good glycemic control. Higher education and SMBG were associated with good glycemic control (P < 0.05). In the SMBG group, tertiary-educated patients had the greatest odds of good glycemic control (odds ratios 2.56; 95% confidence interval 1.31-4.99). Among those performing SMBG, the odds of good glycemic control were higher for those with higher education levels (P = 0.003), whereas there was no clear trend for those not performing SMBG (P = 0.071). For subjects attaining secondary and tertiary education levels, the odds of good glycemic control were higher in those performing SMBG, although there was no significant difference between the two groups for those with a primary education. Glycemic control decreased slightly among males with a primary level education, but showed an increasing trend among females with a primary level education.
Sex-specific educational disparities exist in the association between SMBG and glycemic control. More detailed guidelines for SMBG according to a subject's socioeconomic position and sex are required.
本研究旨在探讨自我血糖监测（SMBG）和受教育程度对 2 型糖尿病（T2DM）患者血糖控制的综合影响。
采用横断面调查方法，对社区 T2DM 居民进行调查。最近一次测量时 HbA1c＜7%定义为血糖控制良好。多变量逻辑回归用于控制某些协变量后，分析血糖控制与 SMBG、受教育程度及其综合效应的关系，并按性别进一步分层。
共纳入 798 例患者，其中 58.52%血糖控制良好。较高的教育程度和 SMBG 与血糖控制良好相关（P＜0.05）。在 SMBG 组中，接受过高等教育的患者血糖控制良好的可能性最大（比值比 2.56；95%置信区间 1.31-4.99）。在进行 SMBG 的患者中，教育程度越高，血糖控制良好的可能性越大（P=0.003），而不进行 SMBG 的患者则无明显趋势（P=0.071）。对于接受过中等和高等教育的患者，进行 SMBG 的患者血糖控制良好的可能性更高，而接受过初等教育的患者则无明显差异。对于接受过初等教育的男性患者，血糖控制略有下降，但对于接受过初等教育的女性患者，血糖控制呈上升趋势。
在 SMBG 与血糖控制之间的关联中，存在性别特异性的教育差异。需要根据患者的社会经济地位和性别制定更详细的 SMBG 指南。
