老年2型糖尿病患者血糖波动的影响因素分析与护理对策

Analysis of influence factors and nursing strategy for glucose variability in type 2 diabetes mellitus patients

目的探讨老年2型糖尿病（T2DM）患者血糖波动的相关影响因素与护理对策。方法 300例动态血糖监测的老年T2DM患者的临床资料,共有160例患者存在血糖波动异常。分析老年T2DM患者血糖波动的相关影响因素,对160例血糖波动患者随机分为对照组和观察组,每组80例,对照组患者给予常规护理措施,观察组患者给予针对性护理措施,统计对比两组患者的血糖情况。结果女性异常血糖波动检出率（71.43%）明显高于男性（47.09%）,差异具有统计学意义（χ2=3.946,P〈0.05）;病程〈10年、10-20年和≥20年患者的异常血糖波动检出率分别为（26.67%VS 50.0%VS 78.13%）,病程≥20年者最高,病程10-20年者次之,病程〈10年者最低,差异具有统计学意义（χ2=4.874,P〈0.05）;Hb A1c≥7.0%患者的异常血糖波动检出率（66.67%）明显高于〈7.0%患者（40.53%）,差异具有统计学意义（χ2=4.077,P〈0.05）。干预1个月后,两组的血糖指标均较干预前明显改善,观察组患者改善程度明显优于对照组,差异具有统计学意义（P〈0.05）。结论老年T2DM患者的血糖波动与性别、病程及Hb A1c水平有关,针对性护理措施能够显著改善患者的血糖情况。

Objective To investigate the related influence factors and nursing strategy for glucose variability in type 2 diabetes mellitus （T2DM） patients. Methods There were clinical data of 300 senile patients with T2DM with continuous glucose monitoring. There were a total of 1.60 patients with abnormal glucose variability, and their related influence factors of senile T2DM were analyzed. These 160 patients were randomly divided into control group and observation group, with 80 cases in each group. The control group received conventional nursing strategy, and observation group received targeted nursing strategy. Comparison was made on the glucose condition between the two groups. Results The detection rate of abnormal glucose variability of female （71.43%） was higher than that of male （47.09%）, and the difference had statistical significance （X^ 2=3.946, P〈0.05）. The detection rate of abnormal glucose variability in patients with course 〈10 years, 20-20 years and ≥ 20 years were （26.67% VS 50.0% VS 78.13%）. Patients with course ≥ 20 years had highest rate, those with 20-20 years were lower and those 〈10 years were the lowest. The difference had statistical significance （X^2=4.874, P〈0.05）. The detection rate of abnormal glucose variability in patients with HbAlc t〉 7.0% （66.67%） was higher than that 〈7.0% （40.53%）. The difference had statistical significance （X^2=4.077, P〈0.05）. After 1 month of intervention, both groups had improved glucose index than that before intervention. The observation group had more obvious improvement than the control group, and the difference had statistical significance （P〈0.05）. Conclusion Glucose variability in senile T2DM patients is corre2ated with gender, course of disease, and HbAlc level. Implement of targeted nursing strategy can improve their glucose condition.