1型糖尿病育龄期女性孕前管理知晓率及其相关因素

Awareness of preconceptional care and its related factors in women of child-bearing age with type 1 diabetes

目的调查1型糖尿病(T1DM)育龄期女性孕前管理知晓率,了解1型糖尿病女性患者疾病自我管理现况,为制定我国1型糖尿病妊娠期疾病管理路径提供依据。方法对2011年6月至2017年12月广东省1型糖尿病转化医学研究项目的成人T1DM开展问卷调查。调查T1DM育龄期女性的孕前管理知晓率并分析相关因素,同时评价育龄期T1DM女性自我血糖监测(SMBG)情况。采用多因素logistic回归分析孕前管理知晓的相关因素。结果本研究共调查广东省1型糖尿病育龄期女性441例,受访时年龄(29.1±7.2)岁。结果显示,广东省1型糖尿病育龄期女性孕前管理知晓率低下(15.42%,68/441)。个人教育水平高(χ^2trend=3.990,P=0.046)、有糖尿病教育后评估(P<0.001)及接受糖尿病教育完整性比例高(生存技能:χ^2=7.525,P=0.004;基本知识:χ^2=8.598,P=0.002;高级知识:P<0.001)的育龄期T1DM女性患者具有较高的孕前管理知晓率。育龄期T1DM女性患者SMBG实施频率为0.29(0.14,2.00)次/d。仅8.5%(37/435)的育龄期T1DM女性SMBG频率达到指南推荐血糖监测标准(≥4次/d),21.1%(92/435)的患者几乎从不进行SMBG。结论广东省育龄期T1DM女性孕前管理知晓率低,SMBG频率显著低于指南推荐水平。

Objective To investigate the awareness of preconception care among women of child-bearing age with type 1 diabetes(T1DM)and their self-management status,in order to provide evidence for establishment of management pathway for women with T1DM in pregnancy in China.Methods This cross-sectional survey recruited female participants of child-bearing age from the cohort of Guangdong Type 1 Diabetes Translational Medicine Study conducted between June 2011 and December 2017.The participants were asked to fill out a questionnaire on the awareness of preconception care,their frequency of self-monitoring of blood glucose(SMBG)and other related variables.Chi-squared test or chi-squared test for trend was used in comparisons of categorical variables,and logistic regression analysis was performed to assess associated factors.Results Totally,441 women of child-bearing age with T1DM were investigated.The results show that their awareness of preconception care was poor(15.42%,68/441).Higher educational level(χ^2trend=3.990,P=0.046),experience of post-diabetes education evaluation(P<0.001),and better coverage of different modules in diabetes education(survival skills:χ^2=7.525,P=0.004;basic knowledge:χ^2=8.598,P=0.002;advanced knowledge:P<0.001)were associated with better awareness of preconception care.The average frequency of SMBG in these participants was 0.29(0.14,2.00)times per day,and only 8.5%(37/435)of them reached the frequency(≥4 times per day)recommended by guidelines.Moreover,21.1%(92/435)of them hardly ever performed SMBG.Conclusion Child-bearing age women with T1DM in Gunangdong had poor awareness of preconception care,with a much lower SMBG frequency than recommendation.