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胰岛素泵教育的一种新方法可改善血糖结果:一项随机对照试验。

A new approach in insulin pump education improves glycemic outcomes: a randomized controlled trial.

作者信息

Rytter Karen, Hougaard Anette, Skouboe Anne Grynnerup, Serifovski Nermin, Ranjan Ajenthen Gayathri, Nørgaard Kirsten

机构信息

Copenhagen University Hospital - Steno Diabetes Center Copenhagen, Borgmester Ib Juuls Vej 83, Herlev, DK-2730, Denmark.

Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, Copenhagen N, DK-2200, Denmark.

出版信息

Acta Diabetol. 2025 Jan;62(1):87-94. doi: 10.1007/s00592-024-02340-y. Epub 2024 Aug 22.

DOI:10.1007/s00592-024-02340-y
PMID:39172172
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11772455/
Abstract

AIMS

To address the scarcity of continued education for insulin pump users, we developed and evaluated a new program (NP) for individuals transitioning to a different insulin pump.

METHODS

In a randomized, controlled 3-month study, adults with type 1 diabetes and suboptimal HbA1c received either NP or usual care program (UC). The NP was designed in collaboration with representatives of the target group and incorporated technical training, case-based learning, and peer experience sharing - encompassing two group sessions, and two follow-up telephone calls. The UC included a single training session led by the pump company with hotline assistance (clinic) but no structured follow-up. The primary endpoint was the difference in time in range (TIR) (70-180 mg/dL (3.9-10.0 mmol/L)), measured by continuous glucose monitoring from baseline to 3 months post-course. Psychosocial self-efficacy was measured by the Diabetes Empowerment Scale (DES-SF).

RESULTS

Thirty-nine participants (median age 43, 74% female) were included. Mean TIR increased significantly in the NP group and remained unchanged in the UC group (between-group difference in change was 13.5% [95% CI: 4.0 to 22.9], p = 0.0064). Psychosocial self-efficacy improved and HbA1c decreased only significantly in the NP group.

CONCLUSIONS

Applying a novel education program at pump transition significantly improved glycemic outcomes and self-efficacy.

摘要

目的

为解决胰岛素泵使用者继续教育资源稀缺的问题,我们开发并评估了一项针对改用不同胰岛素泵的个体的新项目(NP)。

方法

在一项为期3个月的随机对照研究中,1型糖尿病且糖化血红蛋白(HbA1c)未达最佳水平的成年人被随机分配接受NP或常规护理项目(UC)。NP是与目标群体代表合作设计的,包括技术培训、案例学习和同伴经验分享,共包括两次小组会议和两次随访电话。UC包括由泵公司主导的一次培训课程及热线协助(门诊),但没有结构化的随访。主要终点是血糖达标时间(TIR)(70 - 180 mg/dL(3.9 - 10.0 mmol/L))的差异,通过连续血糖监测从基线到课程结束后3个月进行测量。心理社会自我效能感通过糖尿病赋权量表(DES - SF)进行测量。

结果

纳入了39名参与者(中位年龄43岁,74%为女性)。NP组的平均TIR显著增加,而UC组保持不变(组间变化差异为13.5% [95% CI:4.0至22.9],p = 0.0064)。仅NP组的心理社会自我效能感得到改善,糖化血红蛋白显著降低。

结论

在泵转换时应用新的教育项目可显著改善血糖结果和自我效能感。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/35eef1b35a54/592_2024_2340_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/2b34fd64694f/592_2024_2340_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/3f6f0bf19f71/592_2024_2340_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/35eef1b35a54/592_2024_2340_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/2b34fd64694f/592_2024_2340_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/3f6f0bf19f71/592_2024_2340_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/45f1/11772455/35eef1b35a54/592_2024_2340_Fig3_HTML.jpg

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