Liu F, Xie Y T, Xu R, Fan L, Li J, Li X, Huang Z A, Zhou Zhiguang
National Clinical Research Center for Metabolic Diseases, Key Laboratory of Diabetes Immunology, Ministry of Education, Department of Metabolism and Endocrinology, the Second Xiangya Hospital of Central South University, Changsha 410011, China.
Clinic Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha 410011, China.
Zhonghua Yi Xue Za Zhi. 2022 Apr 26;102(16):1202-1208. doi: 10.3760/cma.j.cn112137-20211009-02235.
To evaluate the effect of TELSA structured education program in adults with type 1 diabetes mellitus (T1DM) in China. From January 2019 to January 2020, 64 adult T1DM patients who met the standard of entry and had the intention to participate in TELSA structured education program were selected from the outpatient of type 1 diabetes comprehensive management in the Second Xiangya Hospital as intervention group. A total of 64 patients matched by age and sex were enrolled as the control group. During the program, the intervention group lost 3 cases and the control group lost 4 cases. Finally, there were 61 effective samples in the intervention group and 60 effective samples in the control group. The patients in the control group were given face-to-face education by a T1DM educator for about 2 hours. The patients in the intervention group were intervened according to TELSA structured education program. The level of glycosylated hemoglobin, the frequency of hypoglycemia, self-management ability and quality of life were evaluated before intervention, 6 months after intervention and 12 months after intervention. The ages of the intervention group and the control group were 30.0(22.0,43.5) and 29.5(22.3,42.5) (>0.05), and the proportions of males were 47.54%(29 cases) and 45.00%(27 cases), respectively (>0.05). There were interaction effects (<0.05) on the level of glycosylated hemoglobin, self-management ability and quality of life in the two groups. At 6 and 12 months after intervention of TELSA structured education program, the level of glycosylated hemoglobin in the intervention group decreased from the baseline level (7.87±1.45)% to (7.23±1.06)% and (7.28±0.93)%, respectively, which was significantly lower than that in the control group at 6 months (7.72±1.20)% and at 12 months(7.76±1.24)% (all <0.05). After TELSA structured education intervention, the scores of self-management scale for adult type 1 diabetes mellitus (SMOD-CA) in the intervention group showed an upward trend (<0.001), and the scores of diabetes-specific quality of life scale (A-DQOL) showed a downward trend (<0.001). In contrast, there was no statistically significant difference in the trend of scores in the control group (=0.853 and 0.227). The comparison between groups at different time points showed that at 6 and 12 months after the intervention, the SMOD-CA scores of the patients in the intervention group were higher than those in the control group (<0.001), and the A-DQOL scores were lower than those in the control group (<0.001). The TELSA structured education program can effectively ameliorate glycemic control, with the improvement of self-management ability and quality of life in adult T1DM patients.
评估TELSA结构化教育项目对中国成年1型糖尿病（T1DM）患者的影响。2019年1月至2020年1月，从中南大学湘雅二医院1型糖尿病综合管理门诊选取64例符合入选标准且有意愿参加TELSA结构化教育项目的成年T1DM患者作为干预组。选取64例年龄、性别匹配的患者作为对照组。项目实施过程中，干预组失访3例，对照组失访4例。最终，干预组有效样本61例，对照组有效样本60例。对照组由1名T1DM教育者进行约2小时的面对面教育。干预组按照TELSA结构化教育项目进行干预。分别在干预前、干预后6个月和干预后12个月评估糖化血红蛋白水平、低血糖发生频率、自我管理能力和生活质量。干预组和对照组年龄分别为30.0（22.0，43.5）岁和29.5（22.3，42.5）岁（>0.05），男性比例分别为47.54%（29例）和45.00%（27例）（>0.05）。两组在糖化血红蛋白水平、自我管理能力和生活质量方面存在交互效应（<0.05）。TELSA结构化教育项目干预6个月和12个月时，干预组糖化血红蛋白水平分别从基线水平（7.87±1.45）%降至（7.23±1.06）%和（7.28±0.93）%，显著低于对照组6个月时的（7.72±1.20）%和12个月时的（7.76±1.24）%（均<0.05）。TELSA结构化教育干预后，干预组成人1型糖尿病自我管理量表（SMOD-CA）得分呈上升趋势（<0.001），糖尿病特异性生活质量量表（A-DQOL）得分呈下降趋势（<0.001）。相比之下，对照组得分趋势差异无统计学意义（=0.853和0.227）。不同时间点组间比较显示，干预后6个月和12个月时，干预组患者的SMOD-CA得分高于对照组（<0.001），A-DQOL得分低于对照组（<0.001）。TELSA结构化教育项目可有效改善血糖控制，提高成年T1DM患者的自我管理能力和生活质量。
