Becker Jana, Emmert-Fees Karl M F, Greiner Gregory Gordon, Rathmann Wolfgang, Thorand Barbara, Peters Annette, Karl Florian M, Laxy Michael, Schwettmann Lars
Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ludwig-Maximilians-University Munich, Munich, Germany.
Institute of Health Economics and Health Care Management, Helmholtz Zentrum München GmbH, German Research Center for Environmental Health, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
Prim Care Diabetes. 2020 Oct;14(5):508-514. doi: 10.1016/j.pcd.2020.01.004. Epub 2020 Feb 20.
Self-management behavior (SMB) is an important aspect in the management of diabetes. This study aimed to identify sociodemographic and disease-related factors associated with good SMB in people with type 2 diabetes (T2D).
We used data from 479 people with T2D aged 65 or older from the population-based KORA (Cooperative Health Research in the Area of Augsburg) Health Survey 2016 in Southern Germany. We estimated Poisson and logistic regression models testing the cross-sectional relationship between individual or disease-related characteristics and an established SMB sum index comprising six SMB dimensions stratified according to insulin treatment status.
Mean age in the sample was 75 and mean diabetes duration was 13 years. The overall level of SMB was low. Higher SMB index scores were associated with higher age, treatment with insulin, participation in a diabetes education program, and, for people with insulin treatment, with a BMI below 30 kg/m. Single item analyses generally supported these findings.
SMB in people with T2D needs to be improved with efficient interventions. Targeting obese individuals and those at an early stage of the disease with low-barrier, regular education or self-management programs may be a preferred strategy.
自我管理行为（SMB）是糖尿病管理的一个重要方面。本研究旨在确定与2型糖尿病（T2D）患者良好的自我管理行为相关的社会人口学和疾病相关因素。
我们使用了来自德国南部基于人群的2016年奥格斯堡地区合作健康研究（KORA）健康调查中479名65岁及以上T2D患者的数据。我们估计了泊松回归模型和逻辑回归模型，以检验个体或疾病相关特征与一个既定的自我管理行为总和指数之间的横断面关系，该指数由六个根据胰岛素治疗状态分层的自我管理行为维度组成。
样本的平均年龄为75岁，平均糖尿病病程为13年。自我管理行为的总体水平较低。较高的自我管理行为指数得分与较高年龄、胰岛素治疗、参与糖尿病教育项目有关，对于接受胰岛素治疗的患者，还与体重指数低于30kg/m有关。单项分析总体上支持了这些发现。
T2D患者的自我管理行为需要通过有效的干预措施加以改善。针对肥胖个体和疾病早期阶段的患者，采用低门槛、定期的教育或自我管理项目可能是一种首选策略。
