个案强化管理对门诊新诊断2型糖尿病青年患者自我管理能力及血糖代谢的影响

Effects of individualized intensive management on the self-management and blood glucose metabolism of young patients with newly diagnosed type 2 diabetes mellitus

目的研究个案强化管理对门诊新诊断2型糖尿病青年患者自我管理能力及血糖代谢的干预效果。方法将110例新诊断的2型糖尿病青年患者按就诊日期的单、双号分为对照组(53例)和观察组(57例)。对照组采用常规糖尿病教育,观察组采用个案强化管理流程进行干预。比较2组患者自我护理行为得分、自行停药率和血糖指数的差异。结果观察组糖尿病自护行为得分在干预1个月及3个月后均高于对照组(t=11.274,P<0.001;t=15.741,P<0.001);观察组干预期间自行停药率低于对照组(χ^2=7.351,P=0.007);观察组干预3个月后糖化血红蛋白、空腹血糖和餐后2h血糖均低于对照组(t=2.198,P=0.012;t=1.762,P=0.038;t=2.163,P=0.003)。结论个案强化管理能有效提高新诊断2型糖尿病青年患者的糖尿病自我管理能力,降低自行停药率,提高血糖达标率。

Objective To explore the effect of the individualized intensive management on the self-management and blood glucose metabolism of young patients newly diagnosed with type 2 diabetes mellitus.Methods Totally 110 young patients newly diagnosed with type 2 diabetes were randomly divided into a control group(n=53)and an observation group(n=57)according to the odd or even number of the medical date.The control group was given the routine health education about diabetes,while the observation group was provided with the individualized intensive management.The self-care behavior at 1 month and 3 months after the intervention was compared between the two groups.The difference between the two groups in the glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2hPG),as well as the drug discontinuance rate after the intervention was also observed.Results The scores of the self-care behavior of the observation group at 1 and 3 months after the intervention were significantly higher than those of the control group(t=11.274,P<0.001;t=15.741,P<0.001)at the same time points,while the rate of drug withdrawal of the observation group was significantly lower than that of the control group(χ^2=7.351,P=0.007),and the HbA1c,FPG and 2hPG of the former were lower than the latter(t=2.198,P=0.012;t=1.762,P=0.038;t=2.163,P=0.003).Conclusions The individualized intensive management can effectively improve the self-management,lower the rate of drug withdrawal,and better the blood glucose level.