糖尿病社区干预对2型糖尿病患者血糖水平的影响

顾益玮+朱竹琴+李君+章璞

摘 要 目的：探讨社区干预对2型糖尿病患者空腹血糖与餐后2 h血糖水平的影响。方法：收集2015年2型糖尿病患者100例，分为研究组和对照组各50例，对照组给予常规综合健康教育方式干预，研究组采取KTH糖尿病社区干预的健康教育模式，两组均干预3个月。比较干预前后空腹血糖与餐后2 h血糖水平以及患者的遵医行为变化。结果：在干预前两组空腹血糖、餐后2 h血糖差异无统计学意义（P>0.05）。干预后，研究组空腹血糖、餐后2 h血糖显著低于对照组（P<0.05）。两组干预前的按时复诊、规范服药、血糖自我检测、选择健康生活方式比较差异无统计学意义（P>0.05）。干预后，研究组按时复诊、规范服药、血糖自我检测、选择健康生活方式的比例显著高于对照组（P<0.05）。结论：KTH糖尿病社区干预有利于充分发挥健康教育在糖尿病治疗中的功能，值得社区推广应用。

关键词 糖尿病 社区干预 空腹血糖 餐后2 h血糖

中图分类号：R587.1 文献标志码：A 文章编号：1006-1533（2016）20-0051-03

Effect of diabetic community intervention on fasting blood glucose and postprandial 2 h blood glucose levels in patients with type 2 diabetes

GU Yiwei， ZHU Zhuqin， LI Jun， ZHANG Pu（Yingbo Community Health Service Center of Pudong New District， Shanghai 200126， China）

ABSTRACT Objective： To investigate the effect of community intervention on fasting blood glucose and postprandial 2 h blood glucose levels in patients with type 2 diabetes. Methods： In 2015， a total of 100 cases of type 2 diabetes mellitus were collected and divided into a study group and a control group with 50 cases each. The conventional integrated health education intervention was undertaken in the control group， and the mode of KTH diabetes health education community intervention was used in the study group. Both groups were intervened for three months. Fasting plasma glucose， postprandial 2 h blood glucose levels as well as the compliance behavior change of the patients were compared before and after the intervention. Results： Fasting blood glucose and postprandial 2 h blood glucose levels before the intervention had no significant differences（P>0.05）. After the intervention， fasting blood glucose， and postprandial 2 h blood glucose in the study group were significantly lower than those in the control group（P<0.05）. There were no significant differences in timely referral， standardized medication， blood glucose self-testing and selection of a healthy lifestyle before the intervention between the two groups（P>0.05）. After the intervention， the ratios of timely referral， standardized medication， blood glucose self-testing and selection of a healthy lifestyle in the study group were significantly higher than those in the control group（P<0.05）. Conclusion： KTH diabetic community intervention is beneficial to give full play to the function of health education in the treatment of diabetes， which is worthy of popularization and application in the community.

KEY WORDS diabetes； community intervention； fasting plasma glucose； 2 h postprandial blood glucose

糖尿病在我国患病率增长迅速且作为慢性病根治困难，因此，糖尿病患者大多是经过医生诊断治疗后回归社区进行管理。所以，对于社区预防与控制糖尿病的方法，最有效的方式是通过社区健康促进与行为干预[1-2]。KTH整合式社区干预是融合知信行模式、跨理论模式和健康信念模式开展社区健康教育的干预方法。本研究旨在观察KTH整合式社区干预在2型糖尿病患者空腹血糖与餐后2 h血糖水平的影响。

1 对象和方法

1.1 研究对象

2015年采取随机抽样方法，抽取本社区确诊为2型糖尿病患者100例。纳入标准：①以几乎同年龄（±2岁）、同性别、同婚姻、同文化程度、同职业类型、同病程等配对条件，按照1∶1的比例分为研究组和对照组。②诊断标准依照美国糖尿病协会（ADA）2011年颁布的诊断标准[ 3 ]。③……