动态血糖监测个性化指导对老年2型糖尿病患者精神状态和生活质量的影响

Effect of individualized guidance of dynamic glucose monitoring on mental condition and quality of life of elderly patients with type 2 diabetes mellitus

中文关键词: 老年  2型糖尿病  动态血糖监测  个性化指导  焦虑  抑郁  生活质量

英文关键词: elderly  type 2 diabetes mellitus  dynamic blood glucose monitoring  individualized guidance  anxiety  de-pression  quality of life

中文摘要:

      目的 探讨动态血糖监测个性化指导对老年2 型糖尿病患者精神状态和生活质量的影响.方法 选取2022 年8 月—2023 年7 月于上海交通大学医学院附属第九人民医院内科就诊的老年 2 型糖尿病患者 96 例,并将其随机分为对照组(n =48)和观察组(n =48).观察组采用动态血糖监测个性化指导,对照组采用动态血糖常规监测.干预前和干预2周时,对2 组的焦虑和抑郁情况通过采用心理焦虑自评量表(SAS)、心理抑郁自评量表(SDS)来进行评估;采用医学应对问卷(MCMQ)各项维度进行评分;对空腹血糖(FPG)水平、餐后2h血糖(2 hPG)水平、血糖达标时间进行评估;在患者出院后继续随访8 周,采用健康调查简表(SF-36)评分评估患者的生活质量;评估患者饮食控制依从性情况;并对 2 组评估结果进行分析和比较.结果 干预2 周后,2 组SAS和SDS评分明显低于同组干预前(P＜0.05),观察组SAS和SDS评分明显低于对照组(P＜0.05);2 组MCMQ各项维度评分明显高于同组干预前(P＜0.05),2 组回避、放弃项评分明显低于同组干预前(P＜0.05),观察组MCMQ各项维度评分明显高于对照组(P＜0.05),回避、放弃项评分明显低于对照组(P＜0.05);2 组FPG和2 hPG水平明显低于同组干预前(P＜0.05),观察组FPG、2 hPG水平明显低于对照组(P＜0.05),观察组血糖达标时间明显少于对照组(P＜0.05).出院后继续观察 8 周,2 组SF-36 评分高于同组干预前(P＜0.05),观察组SF-36 评分高于对照组(P＜0.05);观察组饮食控制依从性优于对照组(P＜0.05).结论 采用动态血糖监测个性化指导可促进老年2 型糖尿病患者对疾病的了解程度,从而加强血糖管理,改善患者的精神状态,提高饮食控制依从性和生活质量.

英文摘要:

      Objective To explore the effect of individualized guidance of dynamic blood glucose monitoring on mental condition and quality of life of elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 96 elderly T2DM patients admitted to Department of Endocrinology, Ninth People??s Hospital, Medical College, Shanghai Jiaotong University from August 2022 to July 2023 were selected and randomly divided into control group (n = 48) and observation group (n = 48). The observation group received individualized guidance of dynamic blood glucose monitoring, and the control group re? ceived routine dynamic blood glucose monitoring. Before intervention and 2 weeks after intervention, the anxiety and depres? sion of the two groups were evaluated with the Self?rating Anxiety Scale (SAS) and Self?rating Depression Scale (SDS). All dimensions of the Medical Coping Questionnaire (MCMQ) were scored. The levels of fasting blood glucose (FPG) and 2 h postprandial blood glucose (2 hPG) and time to reach the target of blood glucose were detected. The patients were followed up for 8 weeks after discharge, and their quality of life was evaluated with the Health Survey Short Form (SF?36) score, and the patients?? compliance with dietary control was assessed. The evaluation results of the two groups were analyzed and compared. Results After 2 weeks of intervention, the scores of SAS and SDS of the two groups were significantly lower than those of the same group before intervention (P <0. 05), while the scores of SAS and SDS of the observation group were significantly lower than those of the control group (P < 0. 05). The scores of MCMQ dimensions of both groups were significantly higher than those of the same group before the intervention (P <0. 05), and the scores of avoidance and abandonment items of both groups were significantly lower than those of the same group before the intervention (P <0. 05). The scores of MCMQ dimensions of the observation group were significantly higher than those of the control group (P < 0. 05), and the scores of avoidance and abandonment items were significantly lower than those of the control group (P <0. 05). The levels of FPG and 2 hPG of the two groups were significantly lower than those of the same group before intervention (P <0. 05), while the levels of FPG and 2 hPG of the observation group were significantly lower than those of the control group (P <0. 05). The time to reach the tar? get of blood glucose of the observation group was significantly shorter than that of the control group (P <0. 05). 8 weeks after discharge, the SF?36 scores of the two groups were higher than those of the same group before intervention (P <0. 05), and the SF?36 scores of the observation group were higher than those of the control group (P <0. 05); the compliance of dietary control of the observation group was better than that of the control group (P <0. 05). Conclusion The individualized guid? ance of dynamic blood glucose monitoring can promote the understanding of the disease in the elderly T2DM patients, strength? en blood glucose management, improve their mental state and improve dietary control compliance and quality of life.