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糖尿病 1 型患者中团体教育的显著效果。

Significant effect of group education in patients with diabetes type 1.

机构信息

1st Medical Propedeutic Dept. of Internal Medicine, AHEPA University Hospital, Aristotle University of Thessaloniki, 1 Kiriakidi, 54621, Thessaloniki, Greece.

Endocrinology, Metabolism and Diabetes Unit, Euromedica General Clinic, 11 Marias Kallas & 2 Gravias Streets, 54645, Thessaloniki, Greece.

出版信息

Hormones (Athens). 2018 Sep;17(3):397-403. doi: 10.1007/s42000-018-0054-0. Epub 2018 Aug 15.

Abstract

OBJECTIVE

Type 1 diabetes mellitus (T1DM) constitutes a real challenge in everyday practice for both physicians and patients. Due to the complexity of the disease and its unpredictable nature, structured education and training programs are nowadays implemented that ensure active patient involvement and self-care behaviors to achieve adequate glycemic control, prevent diabetic complications, and improve the quality of life of patients. These programs provide patients with the necessary knowledge and skills to self-monitor and self-manage the disease and its associated metabolic conditions. The aim of the study was to evaluate the effect of a structured 12-month education program that motivated patients to follow a healthy Mediterranean diet and exercise regularly as well as to adjust carbohydrate intake and insulin dose according to their needs.

DESIGN

The education group (EG) was comprised of 62 patients (45 males) with type 1 DM, mean age 36 ± 4.2 years and BMI 24.2 ± 3.1 kg/m. An age- and BMI-matched control group (CG, n = 25, mean age 41 ± 6.4 years, BMI 25.7 ± 4.2 kg/m) was composed of patients referred but not enrolled in the project.

RESULTS

At the end of this program, HbA1C levels were significantly decreased (8.5 ± 2.1% vs. 7.08 ± 0.79%, p < 0.0001) as was also the incidence of hypoglycemic episodes (p < 0.05). Regarding daily glucose fluctuations, significant improvement (p < 0.05) was observed, as reflected in low, high, and daily median glucose values. On the other hand, the above parameters remained stable in the CG.

CONCLUSIONS

These results strongly support the need for long-lasting structured education group courses for adult diabetic patients keen to change their habits in order to achieve self-management of the disease.

摘要

目的

1 型糖尿病(T1DM)对医生和患者来说都是日常实践中的真正挑战。由于疾病的复杂性及其不可预测性,目前实施了结构化的教育和培训计划,以确保患者积极参与并进行自我护理行为,从而实现适当的血糖控制、预防糖尿病并发症,并提高患者的生活质量。这些计划为患者提供了自我监测和管理疾病及其相关代谢状况所需的必要知识和技能。本研究的目的是评估一项结构化的 12 个月教育计划的效果,该计划旨在激励患者遵循健康的地中海饮食,定期锻炼,并根据需要调整碳水化合物摄入和胰岛素剂量。

设计

教育组(EG)由 62 名(45 名男性)1 型糖尿病患者组成,平均年龄 36±4.2 岁,BMI 为 24.2±3.1kg/m。一个年龄和 BMI 匹配的对照组(CG,n=25,平均年龄 41±6.4 岁,BMI 25.7±4.2kg/m)由未参与该项目的患者组成。

结果

在该计划结束时,HbA1C 水平显著降低(8.5±2.1%比 7.08±0.79%,p<0.0001),低血糖事件的发生率也降低(p<0.05)。关于每日血糖波动,观察到显著改善(p<0.05),反映在低、高和每日中位数血糖值上。另一方面,上述参数在 CG 中保持稳定。

结论

这些结果强烈支持需要为渴望改变习惯以实现疾病自我管理的成年糖尿病患者提供长期结构化的教育组课程。

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