一项针对社区中患有2型糖尿病的老年人的糖尿病教育项目结合短信支持对生活方式改变的影响：一项随机对照试验。

Effects of a diabetes education program integrated with text-message support for lifestyle change among older individuals with type 2 diabetes in communities: a randomised controlled trial.

作者信息

Hou M, Qiu W N, Qi H L, Shao H X, Yu J M, Bian H Y

机构信息

School of Public Health, Shanghai Jiao Tong University College of Medicine, Shanghai, 200025, China.

College of Medical, Veterinary and Life Sciences, University of Glasgow, University Avenue, Glasgow, UK.

出版信息

Public Health. 2024 Oct;235:152-159. doi: 10.1016/j.puhe.2024.06.032. Epub 2024 Aug 13.

DOI:10.1016/j.puhe.2024.06.032

PMID:39137656

Abstract

OBJECTIVE

The objective of this study was to investigate the effects of self-management education integrated with text-message support (SME-TMS) on glycaemic control in individuals with type 2 diabetes.

STUDY DESIGN

a randomized, controlled trial.

METHODS

Patients from two communities were randomized into the intervention group (n = 53) or the control group (n = 52). The six-month intervention included the culturally tailored diabetes education and text-messaging support for behaviour changes. The control group received treatment as usual. The primary outcome was reductions in HbA and fasting blood glucose at six-month non-intervention follow-up. Secondary outcomes were reductions in body weight, body mass index (BMI), blood pressure, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, physical activity, and health beliefs.

RESULTS

The intervention led to substantially increase days of weekly physical activity (42% vs. 0%, P < 0.001) and health beliefs (coefficient = 7.0, 95% confidence interval [CI]: 4.4 to 9.6, P < 0.001). However, no greater reduction was found in HbA at six months after the intervention, compared with the control group (0.13%, 95% CI: -0.20 to 0.46, P = 0.443). The reductions of blood pressure, TC, and LDL-C were greater in the control group than in the intervention group (all P < 0.050). Within the intervention group, participants had significant reduction in BMI, whereas the control group had greater reductions in TC and LDL-C (all P < 0.050).

CONCLUSIONS

The SME-TMS intervention led to a greater increase in the weekly physical activity and health belief score in the older patients at 6-month follow-up than with the usual care. Further research is needed to ascertain how these benefits could be translated into favorable medium-and long-term glycaemic control.

TRAIL REGISTRATION NUMBER

This study was registered on Chinese Clinical Trials Registry (ChiCTR2300075112).

摘要

目的

本研究旨在探讨自我管理教育结合短信支持（SME-TMS）对2型糖尿病患者血糖控制的影响。

研究设计

一项随机对照试验。

方法

来自两个社区的患者被随机分为干预组（n = 53）或对照组（n = 52）。为期六个月的干预包括针对文化背景定制的糖尿病教育以及针对行为改变的短信支持。对照组接受常规治疗。主要结局是在六个月的非干预随访期内糖化血红蛋白（HbA）和空腹血糖的降低。次要结局包括体重、体重指数（BMI）、血压、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇、身体活动和健康信念的降低。

结果

干预导致每周身体活动天数大幅增加（42% 对 0%，P < 0.001）以及健康信念增强（系数 = 7.0，95% 置信区间 [CI]：4.4 至 9.6，P < 0.001）。然而，与对照组相比，干预后六个月时HbA的降低幅度并未更大（0.13%，95% CI：-0.20至0.46，P = 0.443）。对照组血压、TC和LDL-C的降低幅度大于干预组（均P < 0.050）。在干预组内，参与者的BMI显著降低，而对照组TC和LDL-C的降低幅度更大（均P < 0.050）。