社区老年人糖尿病患者控制不良的影响因素及干预措施

Influencing factors and intervention strategies of poor control of elderly patients diabetes in Community

目的 探讨社区老年人糖尿病患者控制不良的影响因素,为有针对性的管理糖尿病提供应对措施。方法 2013—2017年间选取该社区卫生服务中心长期在册管理的糖尿病患者(60岁及以上)的空腹血糖检测记录,与其中参与?上海市老年长期照护需求调查?的老人进行匹配。筛选空腹血糖检测记录6次及以上的老年人。最终获得有效样本数为985人。结果 社区老年人糖尿病患者平均控制不良率为18.75%,控制不良的影响因素与教育水平、体质指数(BMI)、完全没有或很少感到疲劳者有关。相较而言,教育水平越高、过轻与肥胖患者、完全没有或很少感到疲劳的患者,血糖控制不良的风险越高。结论 医务人员应该加强对老年糖尿病患者血糖控制意识的引导与教育,促使其建立正确的血糖管理观念及行为,提升患者依从性。重点关注体质指数(BMI)处于过轻或肥胖的糖尿病患者,并帮助其保持良好的身心状态。

Objective To investigate the influential factors of elderly diabetic patients with poorly controlled blood glucose and provide coping strategies for targeted management. Methods According to whether participating in the Shanghai Long-Term Care Needs Assessment Questionnaire or not,985 patients with fasting blood glucose test records(≥6 times)were screened out. Results The average poorly controlled blood glucose rate of elderly diabetic patients was 18.75%.Factors like education level,Body Mass Index(BMI),completely no or rarely felt fatigue were associated with the unsatisfied control of blood glucose.By contrast,the risk of poorly controlled blood glucose was increased with higher education level,underweight and obese person,patients completely no or rarely felt fatigue. Conclusion Medical staffs should help those diabetic patients with poorly controlled blood glucose establishing a correct concept of blood glucose management to improve patient compliance.Medical staffs should pay more attention to these underweight or obese diabetic patients and help them to maintain a good physical and mental state.