1型糖尿病患者胰岛素注射相关自我管理行为及血糖控制现状研究

Study on insulin injection-related self-management behavior and blood glucose control in patients with type 1 diabetes mellitus

目的调查T1DM患者Ins注射相关自我管理行为,并分析其与血糖控制的关系。方法采用便利抽样法选取2016年1月至2019年1月于我院内分泌科门诊、住院和参加夏令营、冬令营等教育活动的T1DM患者289例。采用与Ins注射相关的糖尿病行为评定量表(DBRS)进行调查,并分析其与HbA1c的关系。结果289例T1DM患者自我管理行为得分(0.64±0.15)分,其中Ins笔(0.62±0.15)分,Ins泵(0.67±0.14)分,DBRS各维度Ins注射得分最高。223例(77.16%)T1DM患者自我管理行为得分(0.64±0.15)分。HbA1c平均值为(7.96±1.65)%,其中62.28%高于7.5%。Pearson相关分析显示,T1DM患者自我管理行为及各维度与HbA1c均呈负相关(P<0.05)。Logistic回归分析结果显示,血糖监测与控制(OR 0.091,95%CI 0.024~0.348)、日常基础管理(OR0.113,95%CI 0.025~0.514)、Ins注射管理(OR 0.216,95%CI 0.054~0.855)是T1DM患者HbA1c的影响因素。结论T1DM患者自我管理行为处于中等水平,血糖控制不佳。糖尿病自我管理行为是T1DM患者血糖控制的预测因素,全面提高自我管理行为可改善血糖控制。

ObjectiveTo investigate the self-management behavior related to insulin injection in patients with type 1 diabetes mellitus(T1 DM)and to evaluate its relationship with blood glucose control.MethodsA total of 289 T1 DM patients were selected by convenient sampling from outpatient department,inpatient department,summer camp,winter camp and other educational activities in our hospital from January 2016 to January 2019.The diabetes behavior rating scale(DBRS)related to insulin injection was used to investigate and analyze the relationship between DBRS and HbA1 c.Results ment behavior were(0.64±0.15)in 289 patients with T1 DM.Among them,scores of insulin pen behavior and insulin pump behavior were(0.62±0.15)and(0.67±0.14),respectively.The score of insulin injection was the highest in all dimensions of the scale.The score of the self-management behavior(0.64±0.15)was in the middle level in 223 patients(77.16%).And their average level of HbA1 c was(7.96±1.65)%.62.28%patients had their HbA1 c level of over 7.5%.Pearson correlation analysis showed that all dimensions of self-management behavior were negatively correlated with HbA1 c(P<0.05)in patients with T1 DM.Logistic regression analysis showed that blood glucose monitoring and control(OR 0.091,95%CI0.024~0.348),daily basic management(OR 0.113,95%CI 0.025~0.514),insulin injection management(OR 0.216,95%CI 0.054~0.855)were important influencing factors for HbA1 c in patients with T1 DM.cose control is unsatisfactory.Diabetic self-management behavior is a predictor of blood glucose control in patients with T1 DM.Good self-behavior in patients with T1 DM may improve blood glucose control.