Department of Endocrinology and Metabolism, Shanghai Clinical Center for Diabetes, Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Diabetes Institute, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, China.
Diabetes Metab Res Rev. 2019 Jan;35(1):e3067. doi: 10.1002/dmrr.3067. Epub 2018 Sep 24.
To investigate the association between structured self-monitoring of blood glucose (SMBG) and diabetes self-efficacy in Chinese patients.
This study was a single-centre, open-label, prospective, randomized controlled trial. A total of 250 type 1 and type 2 diabetes patients were recruited and randomly assigned to the structured SMBG group and the control group in a 1:1 ratio. The main outcome observed in this subgroup analysis was a change in the diabetes self-efficacy scale (DSES) scores. A multivariate generalized estimating equation was used to evaluate factors affecting the DSES scores.
We found that the DSES scores tended to decrease significantly with the follow-up time in the intervention group (Wald β = 7.882, P < .001; Wald β = 3.130, P = .003; Wald β = 7.879, P < .001). However, no significant differences in the DSES scores were detected in the control group. Glycaemic control improved in both the intervention and control groups at the third month (P < .05). In the intervention group, sustained improvement of the DSES scores maintained the improvement in glycaemic control through the sixth month. In the control group, glycaemic control tended to deteriorate in the sixth month without the support of an improved DSES scores (P = .056).
Structured SMBG could contribute to the effective and persistent improvement of diabetes self-efficacy. (ClinicalTrials.gov, NCT02225691).
探讨结构化自我血糖监测（SMBG）与中国糖尿病患者自我效能之间的关系。
这是一项单中心、开放标签、前瞻性、随机对照试验。共招募了 250 名 1 型和 2 型糖尿病患者，并以 1:1 的比例随机分配到结构化 SMBG 组和对照组。本亚组分析的主要观察结果是糖尿病自我效能量表（DSES）评分的变化。采用多变量广义估计方程评估影响 DSES 评分的因素。
我们发现，干预组 DSES 评分随随访时间呈显著下降趋势（Wald β=7.882，P<.001；Wald β=3.130，P=.003；Wald β=7.879，P<.001）。然而，对照组 DSES 评分无显著差异。两组的血糖控制在第三个月均有所改善（P<.05）。在干预组中，DSES 评分的持续改善维持了血糖控制的改善，直至第六个月。在对照组中，在没有 DSES 评分改善支持的情况下，血糖控制在第六个月趋于恶化（P=.056）。
结构化 SMBG 有助于有效和持续改善糖尿病自我效能。（ClinicalTrials.gov，NCT02225691）。
