Diabetes Mellitus is a leading cause of death in present world. This study was carried out to evaluate the management, control, complication profile and treatment strategies in patients with diabetes and to determine ...Diabetes Mellitus is a leading cause of death in present world. This study was carried out to evaluate the management, control, complication profile and treatment strategies in patients with diabetes and to determine what extent management of diabetes in a tertiary-care diabetic hospital in Bangladesh adhered to current guidelines. Total 140 diabetic pa- tients (type-1 = 3, type-2 = 137) were randomly selected from outpatient department of a tertiary care diabetic hospital in the Rajshahi city, Bangladesh, during the month of August to September. A standard questionnaire was constructed in local language and interview was administrated. The result was expressed as mean ± SD and the age was 53.2 ± 10.5 yr, duration of diabetes was 6.3 ± 5.6 yr and age at the onset of diabetes was 46.9 ± 9.9 yr. The study group comprised of about 43% male and 57% female with varying risk factors including family history (49%), smoking (11%) and both smoking and family history (4%). Results showed deteriorating glycemic control with mean FBG (fasting blood glucose) and PPG (postprandial blood glucose) level was 8.9 ± 3.6 mmol/L and 11.2 ± 4.7 mmol/L respectively. About 25% patients had FBG level < 6.1 mmol/L, 24% had FBG 6.1 - 7.8 mmol/L and rest 51% had FBG > 7.8 mmol/L. Of the 51% patients with hypertension, 94% were taking anti-hypertensive medicine and 21% patients with dyslipidemia, 59% were treated with lipid lowering agents. Micro-vascular and Macro-vascular complications were reported in 49% and 11% patients respectively. The rates of diabetic complications were cataract 19%, diabetic retinopathy 14%, neuropathy symptoms 35%, nephropathy 6%, MI 6%, cerebral stroke 4% and history of angina pectoris was 7%. Proportion of patients on diet control alone, oral hypoglycemic agent (OHA), insulin and combination of insulin & OHA was 10, 44, 25 and 21 percent respectively. Quality of life evaluation showed that about half of patients have poor quality of life as well as poor adherence to diet, exercise and self testing of blood glucose. In conclusion, majority of the patients were still not satisfactorily controlled. There is an urgent need for effective remedial measures to increase adherence to practice guidelines and to educate both patients and healthcare personnel on importance of achieving clinical targets for metabolic control.展开更多
背景 对初发2型糖尿病(T2DM)患者进行早期干预有助于延缓糖尿病进展。人机交互智能血糖监测管理是一种新型健康干预管理模式,其对初发T2DM患者疾病进展所起作用尚未明确。目的 探讨人机交互智能管理对初发T2DM患者的血糖控制和自我管理...背景 对初发2型糖尿病(T2DM)患者进行早期干预有助于延缓糖尿病进展。人机交互智能血糖监测管理是一种新型健康干预管理模式,其对初发T2DM患者疾病进展所起作用尚未明确。目的 探讨人机交互智能管理对初发T2DM患者的血糖控制和自我管理能力的影响,为T2DM患者管理策略提供参考依据。方法 采用方便抽样法抽取2016年6—12月于天津医科大学朱宪彝纪念医院就诊的初发T2DM患者200例,使用随机数字表法将入组研究对象分为血糖监测组与对照组。血糖监测组除采用人机交互智能血糖监测外其他干预措施同对照组,记录患者入组时和随访3个月后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_(1c))]和糖尿病自我管理能力指标[糖尿病管理自我效能量表(DMSES)、自我管理行为量表(SDSCA)、2型糖尿病患者自护行为量表(2-DSCS)]。结果 随访3个月后,血糖监测组入组95例,对照组入组97例。与干预前相比,两组患者干预后FBG、2 h PG、HbA_(1c)水平均降低(P<0.05),DMSES各项评分升高(P<0.05)。干预后血糖监测组FBG、2 h PG、HbA_(1c)较对照组明显降低(P<0.05)。干预后血糖监测组FBG达标67例(70.5%),对照组达标31例(32.0%),血糖监测组2 h PG达标49例(51.6%);对照组达标30例(30.9%),血糖监测组HbA_(1c)达标67例(70.5%);对照组达标29例(29.9%),以上指标达标率均高于对照组(P<0.05)。血糖监测组DMSES、SDSCA和2-DSCS各项评分均高于对照组(P<0.05)。初发T2DM患者DMSES评分与2-DSCS评分、SDSCA评分呈正相关(r_(s)值分别为0.909和0.872,P<0.01);2-DSCS评分与SDSCA评分呈正相关(r_(s)=0.917,P<0.01)。多元线性回归分析显示,饮食控制、规律锻炼、遵嘱用药、血糖监测和预防及处理高、低血糖行为是HbA_(1c)降低的有利因素(P<0.05);普通饮食、特殊饮食、遵嘱用药是FBG、2 h PG水平降低的有利因素(P<0.05),血糖监测是2 h PG水平降低的有利因素(P<0.05)。结论 人机交互智能血糖监测有效降低初发T2DM患者血糖,促进血糖达标,提升健康行为主观能动性,主要通过提升患者血糖监测、健康饮食、运动、遵嘱用药行为依从性实现血糖管理,为初发T2DM患者提供管理干预方式。展开更多
文摘Diabetes Mellitus is a leading cause of death in present world. This study was carried out to evaluate the management, control, complication profile and treatment strategies in patients with diabetes and to determine what extent management of diabetes in a tertiary-care diabetic hospital in Bangladesh adhered to current guidelines. Total 140 diabetic pa- tients (type-1 = 3, type-2 = 137) were randomly selected from outpatient department of a tertiary care diabetic hospital in the Rajshahi city, Bangladesh, during the month of August to September. A standard questionnaire was constructed in local language and interview was administrated. The result was expressed as mean ± SD and the age was 53.2 ± 10.5 yr, duration of diabetes was 6.3 ± 5.6 yr and age at the onset of diabetes was 46.9 ± 9.9 yr. The study group comprised of about 43% male and 57% female with varying risk factors including family history (49%), smoking (11%) and both smoking and family history (4%). Results showed deteriorating glycemic control with mean FBG (fasting blood glucose) and PPG (postprandial blood glucose) level was 8.9 ± 3.6 mmol/L and 11.2 ± 4.7 mmol/L respectively. About 25% patients had FBG level < 6.1 mmol/L, 24% had FBG 6.1 - 7.8 mmol/L and rest 51% had FBG > 7.8 mmol/L. Of the 51% patients with hypertension, 94% were taking anti-hypertensive medicine and 21% patients with dyslipidemia, 59% were treated with lipid lowering agents. Micro-vascular and Macro-vascular complications were reported in 49% and 11% patients respectively. The rates of diabetic complications were cataract 19%, diabetic retinopathy 14%, neuropathy symptoms 35%, nephropathy 6%, MI 6%, cerebral stroke 4% and history of angina pectoris was 7%. Proportion of patients on diet control alone, oral hypoglycemic agent (OHA), insulin and combination of insulin & OHA was 10, 44, 25 and 21 percent respectively. Quality of life evaluation showed that about half of patients have poor quality of life as well as poor adherence to diet, exercise and self testing of blood glucose. In conclusion, majority of the patients were still not satisfactorily controlled. There is an urgent need for effective remedial measures to increase adherence to practice guidelines and to educate both patients and healthcare personnel on importance of achieving clinical targets for metabolic control.
文摘背景 对初发2型糖尿病(T2DM)患者进行早期干预有助于延缓糖尿病进展。人机交互智能血糖监测管理是一种新型健康干预管理模式,其对初发T2DM患者疾病进展所起作用尚未明确。目的 探讨人机交互智能管理对初发T2DM患者的血糖控制和自我管理能力的影响,为T2DM患者管理策略提供参考依据。方法 采用方便抽样法抽取2016年6—12月于天津医科大学朱宪彝纪念医院就诊的初发T2DM患者200例,使用随机数字表法将入组研究对象分为血糖监测组与对照组。血糖监测组除采用人机交互智能血糖监测外其他干预措施同对照组,记录患者入组时和随访3个月后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA_(1c))]和糖尿病自我管理能力指标[糖尿病管理自我效能量表(DMSES)、自我管理行为量表(SDSCA)、2型糖尿病患者自护行为量表(2-DSCS)]。结果 随访3个月后,血糖监测组入组95例,对照组入组97例。与干预前相比,两组患者干预后FBG、2 h PG、HbA_(1c)水平均降低(P<0.05),DMSES各项评分升高(P<0.05)。干预后血糖监测组FBG、2 h PG、HbA_(1c)较对照组明显降低(P<0.05)。干预后血糖监测组FBG达标67例(70.5%),对照组达标31例(32.0%),血糖监测组2 h PG达标49例(51.6%);对照组达标30例(30.9%),血糖监测组HbA_(1c)达标67例(70.5%);对照组达标29例(29.9%),以上指标达标率均高于对照组(P<0.05)。血糖监测组DMSES、SDSCA和2-DSCS各项评分均高于对照组(P<0.05)。初发T2DM患者DMSES评分与2-DSCS评分、SDSCA评分呈正相关(r_(s)值分别为0.909和0.872,P<0.01);2-DSCS评分与SDSCA评分呈正相关(r_(s)=0.917,P<0.01)。多元线性回归分析显示,饮食控制、规律锻炼、遵嘱用药、血糖监测和预防及处理高、低血糖行为是HbA_(1c)降低的有利因素(P<0.05);普通饮食、特殊饮食、遵嘱用药是FBG、2 h PG水平降低的有利因素(P<0.05),血糖监测是2 h PG水平降低的有利因素(P<0.05)。结论 人机交互智能血糖监测有效降低初发T2DM患者血糖,促进血糖达标,提升健康行为主观能动性,主要通过提升患者血糖监测、健康饮食、运动、遵嘱用药行为依从性实现血糖管理,为初发T2DM患者提供管理干预方式。
