老年糖尿病患者动态血糖监测阶段式强化教育的效果评价

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目的观察动态血糖监测(CGMS)期间进行阶段式强化健康教育对老年2型糖尿病(T2DM)患者血糖控制水平及健康教育效果的近、中期影响。方法老年T2DM患者100例,随机分为试验组和对照组各50例,两组均进行72hCGMS监测,监测前均接受糖尿病知识问卷调查,试验组每日下载血糖数据和图谱并根据结果与生活事件的联系进行针对性健康教育,连续4d,对照组只在72hCGMS结束后根据结果进行一次性教育,之后两组均采用快速血糖仪常规测量指尖多点血糖7d,收集两组患者10d的血糖值及住院天数。3个月后查两组患者的糖化血红蛋白、体重指数并再次进行糖尿病知识问卷调查。CGMS期间其他控制血糖措施两组间无差别。结果试验组10d的血糖均值中空腹血糖、早餐后2h血糖、中餐前血糖、晚餐后2h血糖、睡前血糖、凌晨3点血糖均低于对照组(P<0.05或P<0.01);血糖达标时间、低血糖发生次数、3个月后糖化血红蛋白均低于对照组(P<0.05或P<0.01),糖尿病知识问卷得分高于对照组(P<0.001)。结论CGMS期间应用每24h下载的血糖结果进行阶段式强化教育对老年T2DM患者血糖控制水平及健康教育的近中期效果优于72h一次性进行的教育。 Objective To observe the near and the mid-term effects of stage-based intensive health education on glycemic control and health education in elderly patients with type 2 diabetes mellitus (T2DM) during dynamic glucose monitoring (CGMS). Methods One hundred elderly patients with T2DM were randomly divided into experimental group and control group (n = 50). The two groups were monitored by 72hCGMS. Before the monitoring, they were all surveyed with knowledge of diabetes mellitus. Blood glucose data and maps were downloaded from the experimental group daily. Based on the results and life events Of the link for targeted health education, continuous 4d, the control group only 72hCGMS after the end of a one-time education based on the results, after the two groups were used fast glucose meter routine measurement of fingertips more blood sugar 7d, the two groups were collected 10d blood glucose And hospital days. Three months later, two groups of patients were examined for HbA1c, body mass index, and diabetic knowledge questionnaire again. Other CGM measures during CGMS were indifferent between the two groups. Results In the experimental group, the mean fasting blood glucose (FBG), fasting blood glucose (2h), pre-Chinese fasting blood glucose (2h after breakfast), postprandial blood glucose (2h), pregrowth blood glucose before sleep and 3:00 am blood glucose were lower in the experimental group than those in the control group (P0.05 or P0.01) Hypoglycemic hemoglobin was lower than control group after 3 months (P <0.05 or P <0.01), diabetes knowledge questionnaire score was higher than that of control group (P <0.001). Conclusion During the CGMS period, the blood glucose level in every elderly patients with T2DM and the near and mid-term effects of health education are better than 72-hour one-time education.
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