2型糖尿病患者体质量控制及自我管理行为现状调查
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摘要
目的调查2型糖尿病患者体质量控制及自我管理水平,并探讨两者关联性。方法便利抽样法抽取2018年3-5月在解放军总医院第一医学中心内分泌门诊就诊的205例2型糖尿病患者作为研究对象,采用一般情况调查表和糖尿病自我管理活动问卷(SDSCA)进行调查并分析。结果参与调查的205例中男性104例(50.73%),女性101例(49.27%),平均年龄(56.28±13.14)岁;体质量控制达标(BMI <24 kg/m2)患者仅占34.15%,体质量达标者总体的自我管理各维度水平(除吸烟外)显著优于体质量超重者(P均<0.05);相关性分析显示,患者的饮食自我管理(r=-0.287,P <0.001)、运动自我管理(r=-0.256,P <0.001)、自我血糖监测(r=-0.257,P <0.001)、遵医嘱用药行为(r=-0.173,P=0.013)与体质量指数呈负相关,且体质量指数与糖化血红蛋白呈正相关(r=0.389,P <0.001)。结论糖尿病患者自我管理水平不理想,整体的体质量水平控制不佳。
Objective To investigate the weight control and self-management level of patients with type 2 diabetes mellitus(T2 DM)and explore the correlation between them. Methods Patients were recruited from the endocrinology department,the First Medical Center, Chinese PLA General Hospital through convenience sampling from March to May in 2018. They were investigated by general information questionnaire and Summary of Diabetes Self-care Activities(SDSCA). Results A total of 104(50.73%) males and 101(49.27%) females participated in the survey with an average age of(56.28±13.14) years old. Only 34.15% of the patients achieved the target goal of weight control, whose self-management levels in each dimension(smoking excluded) were higher than those who were overweight(all P < 0.05). Correlation analysis showed that BMI was negatively correlated with diet selfmanagement(r=-0.287, P < 0.001), exercise self-management(r=-0.256, P < 0.001), self-monitoring of blood glucose(r=-0.257,P < 0.001), medication compliance(r=-0.173, P=0.013), and it was positively correlated with HbA1 c(r=0.389, P < 0.001).Conclusion The self-management behaviors and weight control level in type 2 diabetes patients are poor.
Objective To investigate the weight control and self-management level of patients with type 2 diabetes mellitus(T2 DM)and explore the correlation between them. Methods Patients were recruited from the endocrinology department,the First Medical Center, Chinese PLA General Hospital through convenience sampling from March to May in 2018. They were investigated by general information questionnaire and Summary of Diabetes Self-care Activities(SDSCA). Results A total of 104(50.73%) males and 101(49.27%) females participated in the survey with an average age of(56.28±13.14) years old. Only 34.15% of the patients achieved the target goal of weight control, whose self-management levels in each dimension(smoking excluded) were higher than those who were overweight(all P < 0.05). Correlation analysis showed that BMI was negatively correlated with diet selfmanagement(r=-0.287, P < 0.001), exercise self-management(r=-0.256, P < 0.001), self-monitoring of blood glucose(r=-0.257,P < 0.001), medication compliance(r=-0.173, P=0.013), and it was positively correlated with HbA1 c(r=0.389, P < 0.001).Conclusion The self-management behaviors and weight control level in type 2 diabetes patients are poor.
引文
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3 Rothberg AE,Mc Ewen LN,Kraftson AT,et al.Very-low-energy diet for type 2 diabetes:an underutilized therapy?[J].J Diabetes Complications,2014,28(4):506-510.
4 Inzucchi SE,Bergenstal RM,Buse JB,et al.Management of hyperglycemia in type 2 diabetes,2015:a patient-centered approach:update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes[J].Diabetes Care,2015,38(1):140-149.
5 Parretti HM,Jebb SA,Johns DJ,et al.Clinical effectiveness of very-low-energy diets in the management of weight loss:a systematic review and meta-analysis of randomized controlled trials[J].Obes Rev,2016,17(3):225-234.
6 American Diabetes Association.Standards of Medical Care in Diabetes-2017[J].Diabetes Care,2017,40(Suppl 1):S1-S135.
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10孙胜男,赵维纲,董颖越,等.糖尿病患者自我管理现状及影响因素分析[J].中华护理杂志,2011,46(3):229-233.
11中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
12周帆,王先令,窦京涛.从2017年版ADA指南看2型糖尿病患者肥胖管理新策略[J].药品评价,2018,15(3):10-13.
13 Williamson DF,Thompson TJ,Thun M,et al.Intentional weight loss and mortality among overweight individuals with diabetes[J].Diabetes Care,2000,23(10):1499-1504.
14 American Heart Association,American College of Cardiology;Obesity Society..Reprint:2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults[J].J Am Pharm Assoc(2003),2014,54(1):e3.
15 Hou X,Lu J,Weng J,et al.Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults:a national diabetes and metabolic disorders survey[J].PLo S One,2013,8(3):e57319.
16何叶,绳宇.空巢老年糖尿病患者自我管理水平和生存质量的相关性研究[J].中华护理杂志,2013,48(2):136-138.
17 Washington G,Wang-Letzkus MF.Self-care practices,health beliefs,and attitudes of older diabetic Chinese Americans[J].JHealth Hum Serv Adm,2009,32(3):305-323.
18 Wing RR,Bolin P,Brancati FL,et al.Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes[J].N Engl J Med,2013,369(2):145-154.
19李良秀,高峦,郎秋颖,等.基于互联网的糖尿病管理干预研究现状[J].中国护理管理,2017,17(7):967-970.
20 Feldstein AC,Nichols GA,Smith DH,et al.Weight change in diabetes and glycemic and blood pressure control[J].Diabetes Care,2008,31(10):1960-1965.
2 Chiu M,Austin PC,Manuel DG,et al.Deriving ethnic-specific BMI cutoff points for assessing diabetes risk[J].Diabetes Care,2011,34(8):1741-1748.
3 Rothberg AE,Mc Ewen LN,Kraftson AT,et al.Very-low-energy diet for type 2 diabetes:an underutilized therapy?[J].J Diabetes Complications,2014,28(4):506-510.
4 Inzucchi SE,Bergenstal RM,Buse JB,et al.Management of hyperglycemia in type 2 diabetes,2015:a patient-centered approach:update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes[J].Diabetes Care,2015,38(1):140-149.
5 Parretti HM,Jebb SA,Johns DJ,et al.Clinical effectiveness of very-low-energy diets in the management of weight loss:a systematic review and meta-analysis of randomized controlled trials[J].Obes Rev,2016,17(3):225-234.
6 American Diabetes Association.Standards of Medical Care in Diabetes-2017[J].Diabetes Care,2017,40(Suppl 1):S1-S135.
7 Hewitt J,Smeeth L,Chaturvedi N,et al.Self management and patient understanding of diabetes in the older person[J].Diabet Med,2011,28(1):117-122.
8叶任高,陆再英.内科学[M].北京:人民卫生出版社,2004:797.
9 Toobert DJ,Hampson SE,Glasgow RE.The summary of diabetes self-care activities measure:results from 7 studies and a revised scale[J].Diabetes Care,2000,23(7):943-950.
10孙胜男,赵维纲,董颖越,等.糖尿病患者自我管理现状及影响因素分析[J].中华护理杂志,2011,46(3):229-233.
11中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-67.
12周帆,王先令,窦京涛.从2017年版ADA指南看2型糖尿病患者肥胖管理新策略[J].药品评价,2018,15(3):10-13.
13 Williamson DF,Thompson TJ,Thun M,et al.Intentional weight loss and mortality among overweight individuals with diabetes[J].Diabetes Care,2000,23(10):1499-1504.
14 American Heart Association,American College of Cardiology;Obesity Society..Reprint:2013 AHA/ACC/TOS Guideline for the Management of Overweight and Obesity in Adults[J].J Am Pharm Assoc(2003),2014,54(1):e3.
15 Hou X,Lu J,Weng J,et al.Impact of waist circumference and body mass index on risk of cardiometabolic disorder and cardiovascular disease in Chinese adults:a national diabetes and metabolic disorders survey[J].PLo S One,2013,8(3):e57319.
16何叶,绳宇.空巢老年糖尿病患者自我管理水平和生存质量的相关性研究[J].中华护理杂志,2013,48(2):136-138.
17 Washington G,Wang-Letzkus MF.Self-care practices,health beliefs,and attitudes of older diabetic Chinese Americans[J].JHealth Hum Serv Adm,2009,32(3):305-323.
18 Wing RR,Bolin P,Brancati FL,et al.Cardiovascular effects of intensive lifestyle intervention in type 2 diabetes[J].N Engl J Med,2013,369(2):145-154.
19李良秀,高峦,郎秋颖,等.基于互联网的糖尿病管理干预研究现状[J].中国护理管理,2017,17(7):967-970.
20 Feldstein AC,Nichols GA,Smith DH,et al.Weight change in diabetes and glycemic and blood pressure control[J].Diabetes Care,2008,31(10):1960-1965.