对成年2型糖尿病患者基于移动APP+家属共管血糖的研究

Mobile APP plus family management of blood glucose for adult patients with type 2 diabetes

目的评价成年2型糖尿病患者应用移动APP+家属共管血糖改善自我管理行为和血糖控制的有效性及可持续性。方法选取2022年5月—2023年6月广州市某三级甲等医院的成年2型糖尿病患者作为研究对象,将患者随机分为对照组(n=69)和试验组(n=68)。对照组采用移动APP血糖管理模式,试验组采用移动APP+家属共管血糖模式。观察并比较干预前、干预3个月末、干预6个月末2组空腹血糖、糖化血红蛋白、糖尿病自我管理行为量表、家庭成员行为量表、照顾者负担量表的变化和得分差异。由于这5个指标均不服从正态分布,所以在分析之前对其分别做基于秩次的逆正态变换(INT)。结果干预前2组的INT变换后空腹血糖、糖化血红蛋白、糖尿病自我管理行为量表、糖尿病患者家庭成员行为量表和照顾者负担量表得分差异均无统计学意义(P>0.05)。试验组3个月末和6个月末的INT变换后糖尿病自我管理行为量表得分、空腹血糖、糖化血红蛋白均优于对照组(P<0.05)。相较于干预前,试验组干预3个月末的INT变换后糖尿病自我管理行为量表得分升高;干预3个月末和6个月末的INT变换后空腹血糖、糖化血红蛋白、照顾者负担量表得分降低,INT变换后家庭成员行为量表得分升高。结论移动APP+家属共管血糖可以增加家庭支持水平,改善患者自我管理行为和血糖控制,且不增加家属照顾负担。研究者停止干预3个月后,患者仍然具有良好的血糖控制水平,可在2型糖尿病患者居家智能血糖管理中推广。

Objective To evaluate the effectiveness and sustainability of self-management behaviors and blood glucose control in adult patients with type 2 diabetes using mobile APP plus family management of blood glucose.Methods Adult patients with type 2 diabetes from a tertiary grade-A hospital in Guangzhou from May 2022 to June 2023 were selected as research subjects and randomly divided into control group(n=69)and experimental group(n=68).The control group adopted blood glucose management with mobile APP,and the experimental group employed the mode of mobile APP plus family management of blood glucose.The changes and score differences of fasting blood glucose,glycosylated hemoglobin,Diabetes Self-management Behavior Scale,Family Member Behavior Scale,and Caregiver Burden Scale before the intervention,3 and 6 months after the intervention were observed and compared between the two groups.Due to the non-normal distribution of these 5 indicators,inverse rank-based normal transformation(INT)was performed on them before analysis.Results There was no statistical difference(P>0.05)in the INT-transformed score of fasting blood glucose,glycosylated hemoglobin,Diabetes Self-management Behavior Scale,Family Member Behavior Scale,and Caregiver Burden Scale between the two groups before intervention.The experimental group showed higher score of Diabetes Self-management Behavior Scale,fasting blood glucose and glycosylated hemoglobin than the control group 3 and 6 months after the intervention(P<0.05).After the intervention,the experimental group had higher INT-transformed score of Diabetes Self-management Behavior Scale 3 months after intervention;lower INT-transformed score of fasting blood glucose,glycosylated hemoglobin and Caregiver Burden Scale 3 and 6 months after the intervention,and higher INT-transformed score of Family Member Behavior Scale.Conclusion Mobile APP plus family management of blood glucose can promote family support,and improve patient self-management behaviors and blood glucose control,while without increasing family care burden.Three months after the intervention,patients still have good blood glucose control,consequently,this mode can be promoted in home intelligent blood glucose management for patients with type 2 diabetes.