社区2型糖尿病患者自我血糖监测现状及影响因素分析

Status of and Influencing Factors for the Self-monitoring of Blood Glucose in Type 2 Diabetes

目的探讨社区2型糖尿病患者自我血糖监测(SMBG)现状及相关影响因素。方法 2014年1月从上海市瑞金二路街道社区卫生服务中心在册管理的糖尿病患者中以随机数字表法抽取符合纳入与排除标准的2型糖尿病患者245例,根据患者SMBG判定标准将患者分为达标组和不达标组。记录患者年龄、性别、文化程度、月平均收入、婚姻状况、糖尿病病程、医疗保险类型、SMBG技能、自备血糖监测仪、试纸价格、血糖测试便利性、定期SMBG必要性、糖尿病教育、糖尿病自我效能量表评分,并进行SMBG影响因素分析。结果达标组32例(13.1%),不达标组213例(86.9%)。两组患者文化程度、医疗保险类型、有无SMBG技能、有无自备血糖监测仪、糖尿病自我效能量表评分比较,差异有统计学意义(P<0.05);两组患者年龄、性别构成、月平均收入、婚姻状况、糖尿病病程、血糖试纸价格、血糖测试便利性、定期SMBG必要性、糖尿病教育比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,医疗保险类型、SMBG技能为SMBG的独立影响因素(P<0.05)。结论社区2型糖尿病患者SMBG达标率欠佳,应加强2型糖尿病患者SMBG技能教育,降低血糖监测费用,提高SMBG达标率。

Objective To investigate and discuss the current status of and influencing factors for self-monitoring of blood glucose（ SMBG） in patients with type 2 diabetes in community. Methods In January 2014,using random number table method,we enrolled 245 type 2 diabetes patients who accorded with the inclusion and exclusion criteria and were registered and administrated by Ruijinerlu Community Health Service Center of Huangpu District in Shanghai. According to SMBG criteria,we divided patients into standard-reaching group and non-standard-reaching group. We recorded age,gender,education level,average monthly income,marital status,the disease course of diabetes,types of medical insurance,the know-how of SMBG,self-prepared blood glucose monitor, price of test paper, convenience of blood glucose test, necessity of regular SMBG,education on diabetes,score of DSES,and the influencing factors for SMBG were analyzed. Results There were 32（ 13. 1%）patients in standard-reaching group and 213（ 86. 9%） patients in non-standard-reaching group. The two groups were significantly different（ P〈0. 05） in education level,type of medical insurance,the know how of SMBG,self-prepared blood glucose monitor and score of DSES; the two groups were not significantly different（ P〉0. 05） in age, gender composition,average monthly income,marital status,disease course of diabetes,price of test paper on blood glucose,convenience of blood glucose test,necessity of regular SMBG and education on diabetes. Multivariate Logistic regvession analysis showed that the type of medical insurance and know-how of SMBG were independent influencing factor for SMBG（ P〈0. 05）. Conclusion The standard-reaching rate of SMBG in patients with type 2 diabetes in community is low. The education of SMBG know-how should be promoted, the expenditure on blood glucose monitor should be lowered, so as to improve the standard-reaching rate of SMBG.