中国全科医学 ›› 2025, Vol. 28 ›› Issue (07): 777-796.DOI: 10.12114/j.issn.1007-9572.2024.0548

• 指南·共识 •    

中国糖尿病行为与生活方式干预指南(2024版)

中华预防医学会糖尿病预防与控制专业委员会   

  • 收稿日期:2024-10-14 修回日期:2024-11-21 出版日期:2025-03-05 发布日期:2025-01-23
  • 基金资助:
    首都卫生发展科研专项项目(2022-1G-2064); 北京市朝阳区科技计划项目(CYSF2113)

Chinese Diabetes Behavior and Lifestyle Intervention Guidelines (2024)

Diabetes Prevention and Control Committee of Chinese Preventive Medicine Association   

  • Received:2024-10-14 Revised:2024-11-21 Published:2025-03-05 Online:2025-01-23

摘要: 行为与生活方式干预(behavior and lifestyle interventions,BLIs)可以降低血糖和血压,调节血脂,控制肥胖,减少心血管事件,是糖尿病等慢性病的一线治疗措施。BLIs包括帮助患者维护健康饮食、坚持体育锻炼、保持正常体重、保证良好睡眠、避免吸烟和酗酒、做好心理调适、建立良好的社会支持、进行科学的血糖自我监测、坚持降糖药治疗等。除了出现严重高血糖及糖尿病急性并发症需要立即进行药物治疗外,新诊断的2型糖尿病患者应首先进行BLIs。BLIs应遵循有效性、建立互信、问题解决导向、综合性和个性化原则。常用干预策略包括应用成熟的行为改变理论、使用行为改变技术、有效运用传播策略、提高患者行为技能、实施以人为本的患者自我管理教育和支持。基本步骤包括行为与生活方式及其影响因素评估、确定行为目标、制定干预实施方案、实施干预和评价效果。BLIs效果评价指标包括过程指标、临床结局、社会心理、行为结局、患者报告和健康结局。效果评价可采用定性和定量相结合的方法进行,常用的评价工具包括糖尿病自我护理行为评价量表(summary of diabetes self-care activities,SDSCA)、患者行为量表(patient activation measurement,PAM)和糖尿病管理自我效能量表(diabetes management self-efficacy scale,DMSES)。

关键词: 糖尿病, 高血糖, 高脂血症, 高血压, 行为与生活方式干预

Abstract:

Behavior and lifestyle interventions (BLIs) can reduce blood glucose and blood pressure, regulate blood lipids, control obesity, reduce cardiovas cular events and are a first-line treatment for chronic diseases such as diabetes mellitus. BLIs include helping patients maintain a healthy diet, adhere to physical exercise, maintain a normal weight, ensure good sleep, avoid smoking and alcohol abuse, make good psychological adjustments, establish good social support, as well as scientific self-monitoring of blood glucose and adherence to drug therapy. Except for the severe hyperglycemia and acute complications requiring medication, patients with newly diagnosed diabetes mellitus should first undergo BLIs. BLIs should follow the principles of effectiveness-centered, mutual trust establishment, problem-solving orientation, integration, and individulization. Common strategies for BLIs include applying behavior change theories, utilizing behavior change technologies, effectively emlpoying communication strategies, improving patient behavior skills, and implementing patient-centered self-management education and support (DSMES). The steps of BLIs include evaluating behavior, lifestyle and their influencing factors, setting behavioral goals, developing intervention plans, and conducting interventions and effectiveness evaluation. The evaluation measures for the effectiveness of BLIs include process indicators, clinical outcomes, socio-psychological and behavioral outcomes, patient reports, and health outcomes. Evaluation can be performed using a combination of qualitative and quantitative methods. Common evaluation tools include the SDSCA, PAM, and DMSES.

Key words: Diabetes mellitus, Hyperglycemia, Hyperlipidemia, Hypertension, Behavior and lifestyle interventions

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