Uchida Taisuke, Ueno Hiroaki, Sekishima Akari, Sekishima Hirotaka, Konagata Ayaka, Nakamura Takayuki, Kogo Fumiko, Nabekura Hiroki, Tanaka Yuri, Shimizu Koichiro, Yamaguchi Hideki, Shimoda Kazuya
Division of Hematology, Diabetes, and Endocrinology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki 889-1692 Japan.
Diabetol Int. 2024 Mar 29;15(3):439-446. doi: 10.1007/s13340-024-00710-z. eCollection 2024 Jul.
Education on insulin self-injection techniques is important for good glycemic control, but its effectiveness in some elderly patients is limited due to loss of cognitive function and impaired activities of daily living. We hypothesized that classification using the Dementia Assessment Sheet for Community-based Integrated Care System 8-items (DASC-8) would help identify elderly patients with diabetes who effectively learn self-injection techniques.
Diabetes patients aged ≥ 65 years who used a self-injection insulin pen were administered the DASC-8 and a questionnaire to evaluate insulin self-injection techniques, and then received technical education. The questionnaire was administered again 4 months later, and patients were classified into the education-effective and education-ineffective groups. The achievement of HbA1c targets defined for each patient according to guidelines based on DASC-8 category was examined over 12 months.
76 Japanese patients (median age 72.0 years and 53.9% female) with DASC-8 categories I (n = 55), II (n = 13), and III (n = 8) were enrolled. In the education-effective group, the percentage of patients in category I was significantly higher than that of patients in category II or III (92.0% to 23.8%, P < 0.001). Category I was independently associated with education effectiveness (odds ratio 14.50, 95% confidence interval: 2.110-100.0, P = 0.007). Category I patients in the education-effective group showed significantly improved achievement of target HbA1c from baseline to the 12th month (from 27.6% to 62.1%, P = 0.008).
The DASC-8 was a useful indicator for identifying elderly patients who would benefit from education on self-injection techniques.
The online version contains supplementary material available at 10.1007/s13340-024-00710-z.
胰岛素自我注射技术教育对于良好的血糖控制很重要，但在一些老年患者中，由于认知功能丧失和日常生活活动能力受损，其效果有限。我们假设使用社区综合护理系统8项痴呆评估表（DASC - 8）进行分类有助于识别能有效学习自我注射技术的老年糖尿病患者。
对年龄≥65岁且使用胰岛素笔自我注射的糖尿病患者进行DASC - 8评估和一份用于评估胰岛素自我注射技术的问卷，然后接受技术教育。4个月后再次进行问卷调查，并将患者分为教育有效组和教育无效组。在12个月内，根据基于DASC - 8分类为每位患者定义的糖化血红蛋白（HbA1c）目标达成情况进行检查。
纳入了76名日本患者（中位年龄72.0岁，女性占53.9%），DASC - 8分类为I类（n = 55）、II类（n = 13）和III类（n = 8）。在教育有效组中，I类患者的比例显著高于II类或III类患者（92.0%对23.8%，P < 0.001）。I类与教育有效性独立相关（比值比14.50，95%置信区间：2.110 - 100.0，P = 0.007）。教育有效组中的I类患者从基线到第12个月糖化血红蛋白目标达成情况有显著改善（从27.6%到62.1%，P = 0.008）。
DASC - 8是识别能从自我注射技术教育中受益的老年患者的有用指标。
在线版本包含可在10.1007/s13340 - 024 - 00710 - z获取的补充材料。
