中国全科医学 ›› 2023, Vol. 26 ›› Issue (15): 1817-1823.DOI: 10.12114/j.issn.1007-9572.2022.0784

• 住院血糖监测专题研究 • 上一篇    下一篇

人机交互智能管理对初发2型糖尿病患者血糖控制的影响研究

王凌霄, 董荣娜, 周冰, 郭丽娜, 李晶*()   

  1. 300134 天津市,天津医科大学朱宪彝纪念医院 天津市内分泌研究所 国家卫健委激素与发育重点实验室 天津市代谢性疾病重点实验室
  • 收稿日期:2022-07-25 修回日期:2023-01-25 出版日期:2023-05-20 发布日期:2023-02-01
  • 通讯作者: 李晶

  • 作者贡献:王凌霄、董荣娜进行研究的构思与设计、研究的可行性分析、文献收集、数据整理,撰写论文;周冰、郭丽娜参与数据收集与整理;王凌霄、周冰进行论文的修订;李晶负责文章的质量控制及审校,监督管理,对文章整体负责;所有作者确认了论文的最终稿。
  • 基金资助:
    天津市教育委员会哲学社会科学重点项目--天津市代谢性慢病防控体系的构建研究(2019JWZD54); 天津医科大学朱宪彝纪念医院科研基金--"三一照护"糖尿病诊疗模式卫生经济学评价(2019ZXY04); 天津医科大学医院管理创新研究项目--后疫情时代基于柏拉图分析法研究医院的科研管理模式(2020YG20)

Analysis of the Effect of Human-computer Interaction Intelligent Management on Blood Glucose Control in New-onset Type 2 Diabetes Mellitus Patients

WANG Lingxiao, DONG Rongna, ZHOU Bing, GUO Lina, LI Jing*()   

  1. Tianjin Medical University, Chu Hsien-I Memorial Hospital/Tianjin Institute of Endocrinology/NHC Key Laboratory of Hormones and Development/Tianjin Key Laboratory of Metabolic Diseases, Tianjin 300134, China
  • Received:2022-07-25 Revised:2023-01-25 Published:2023-05-20 Online:2023-02-01
  • Contact: LI Jing

摘要: 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。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 hPG)、糖化血红蛋白(HbA1c)〕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 hPG、HbA1c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 hPG、HbA1c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 hPG达标49例(51.6%);对照组达标30例(30.9%),血糖监测组HbA1c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(rs值分别为0.909和0.872,P<0.01);2-DSCS评分与SDSCA评分呈正相关(rs=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HbA1c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 hPG水平降低的有利因素(P<0.05),血糖监测是2 hPG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。

关键词: 糖尿病, 2型, 人机交互, 血糖管理, 自我管理行为, 管理自我效能

Abstract:

Background

Early intervention of blood glucose control in patients with new-onset type 2 diabetes mellitus (T2DM) can help delay the progression of diabetes. As a new form of health management, the effect of human-computer interaction intelligent blood glucose monitoring management on the progression of new-onset T2DM patients has not been clarified.

Objective

To explore the effect of human-computer interaction intelligent management on blood glucose control and self management capability in new-onset T2DM patients, so as to provide the reference for optimizing the control strategy in new-onset T2DM patients.

Methods

From June 2016 to December 2016, 200 patients with new-onset T2DM admitted to the Tianjin Medical University, Chu Hsien-I Memorial Hospital were selected by convenient sampling and randomly divided into the control group (n=100) and the monitoring group (n=100). The interventions in the monitoring group were the same as those in the control group except for the human-computer interaction intelligent monitoring. Blood glucose indexes〔fasting blood glucose (FBG), 2 h postprandial glucose (2 hPG) and glycated hemoglobin (HbA1c) 〕and self-management capability indexes〔diabetes management self-efficacy scale (DMSES), summary of diabetes self-care activities (SDSCA), diabetes self-care scale (2-DSCS) 〕were recorded at the time of enrollment and after 3 months of follow-up in the two groups.

Results

After 3 months of follow-up, the monitoring group included 95 cases, the control group included 97 cases. Compared with the pre-intervention period, FBG, 2 hPG and HbA1c levels decreased in both groups after the intervention (P<0.05), and the scores of DMSES scores increased in both groups (P<0.05). FBG, 2 hPG and HbA1c were significantly lower in the post-intervention period of glucose monitoring group compared with the control group (P<0.05). 67 patients (70.5%) in the monitoring group reached the target level of FBG, 31 patients (32.0%) in the control group as well; besides 49 patients (51.6%) in the monitoring group reached the target level of 2 hPG, 30 patients (30.9%) in the control group as well; moreover, 67 patients (70.5%) in the monitoring group reached the target level of HbA1c, 29 cases (29.9%) in the control group as well, all the above rates of reaching in the monitoring group was higher than those in the control group (P<0.05). The total DMSES score, 2-DSCS score and SDSCA score in the monitoring group were higher than those in the control group (P<0.05). The score of DMSES in new-onset T2DM patients was positively correlated with the scores of 2-DSCS and SDSCA (rs=0.909, 0.872, P<0.01). The 2-DSCS scale score was positively correlated with the SDSCA scale score (rs=0.917, P<0.01). Multiple regression analysis showed that diet control, regular exercise, taking medication as instructed, blood glucose monitoring, prevention and management of high and low blood glucose behaviors were favorable factors for HbA1c reduction (P<0.05). The general diet, special diet and taking medication as instructed were the favorable factors for FBG and 2 hPG levels reduction (P<0.05), and the blood glucose monitoring was positive for 2 hPG levels reduction.

Conclusion

Human-computer interaction intelligent management was able to improve blood glucose control of new-onset T2DM patients effectively, which can promote the reaching to target blood glucose level, the subjective initiative of health behavior mainly through improving compliance of blood glucose monitoring, healthy diet, exercise and taking medication as instructed, which provide advice on effective intervention methods for new-onset T2DM patient management.

Key words: Diabetes mellitus, type 2, Human-computer interaction, Blood glucose control, Self-care behavior, Management self-efficacy