饮食强化管理及运动指导在糖尿病患者自我管理中的应用效果

Effects of intensive dietary management and exercise instruction on self-management of diabetes mellitus

目的探讨饮食强化管理及运动指导在糖尿病患者自我管理中的应用效果。方法选取2015年11月至2016年11月于首都医科大学附属北京天坛医院就诊的糖尿患者120例，完全随机分为对照组和观察组，各60例。所有患者入院后均实施常规检查后予以降糖、降脂等常规治疗，对照组予以常规护理，观察组实施饮食强化管理及运动指导。比较2组患者入组时及干预3个月后的血糖控制情况、糖尿病相关知识知晓率、相关管理标准化效应评价及自我管理能力评分。结果干预后，2组空腹血糖、餐后2 h血糖及糖化血红蛋白水平均较治疗前降低，且观察组低于对照组［（7.1±2.0）mmol/L比（8.3±1.9）mmol/L、（9.5±1.8）mmol/L比（10.3±2.4）mmol/L、（6.00±0.20）%比（6.20±0.60）%］，差异均有统计学意义（均P＜0.05）。干预后，观察组患者糖尿病相关知识知晓率明显高于对照组，差异有统计学意义（P＜0.05）。干预后，观察组相关管理标准化效应评价评分、自我管理能力评分及分级在一般以上比例明显高于对照组，差异均有统计学意义（均P＜0.05）。结论对糖尿病患者实施饮食强化管理及运动指导，不仅可有效提高患者自我管理能力，增强相关知识的掌握程度，还有利于血糖的控制。

ObjectiveTo discuss effects of intensive dietary management and exercise instruction on self-management of patients with diabetes mellitus. MethodsTotally 120 patients with diabetes were enrolled from November 2015 to November 2016 in Beijing Tiantan Hospital, Capital Medical University; they were randomly divided into control group and observation group, with 60 cases in each group. All patients had routine laboratory examination and blood glucose and lipid lowering therapy; the control group had conventional nursing care; the observation group had intensive dietary management and exercise instruction. Glycemic control, awareness of diabetes knowledge, effects on standardized management and self-management were analyzed before and 3 months after intervention. ResultsAfter intervention, levels of fasting blood glucose, postprandial 2 h blood glucose and glycosylated hemoglobin significantly decreased compared to those before intervention; levels of fasting blood glucose, postprandial 2 h blood glucose and glycosylated hemoglobin in observation group were significantly lower than those in control group[（7.1±2.0）mmol/L vs （8.3±1.9）mmol/L, （9.5±1.8）mmol/L vs （10.3±2.4）mmol/L, （6.00±0.20）% vs （6.20±0.60）%]（P〈0.05）. The awareness rate of diabetes knowledge in observation group was significantly higher than that in control group（P〈0.05）. Scores of standardized management evaluation and self-management ability in observation group were significantly higher than those in control group（P〈0.05）. ConclusionIntensive dietary management and exercise instruction contribute to enhancing self-management and increasing knowledge about diabetes, which are beneficial to blood glucose control in diabetic patients.