Abstract: Background　Poor treatment adherence and glycemic control are common in older adults with diabetes. Diet is strongly associated with glycemic control，so studying diet management will greatly contribute to prognosis improvement of diabetic patients. Objective　To examine the effect of a self-made diabetic diet manager in empty nesters with type 2 diabetes and poor glycemic control. Methods　Participants were 120 empty nesters with type 2 diabetes and poor glycemic control selected from the Third Affiliated Hospital of Gansu University of Chinese Medicine，including 60 hospitalized between February and October 2018（traditional group with 6-month-follow-up routine health education），and 60 hospitalized between February and October 2019（diabetic diet manager group with 6-month-follow-up intervention using a diabetic diet manager developed by our research group）. Medical records and complete follow-up data were collected retrospectively. Pre- and post-follow-up fasting and two-hour postprandial glucose levels and self-care ability（evaluated by the Summary of Diabetes Self-care Activities）of two groups were compared. The complications and readmission of the two groups during intervention were observed and recorded. Results　After 6 months of intervention，the fasting blood glucose，two-hour postprandial blood glucose and glycated hemoglobin levels fell notably in both groups（P<0.05），and they decreased more significantly in diabetic diet manager group（P<0.05）. Both groups had an obvious increase in the scores of successful self-management of diet and exercise，blood glucose self-monitoring and taking medicines as prescribed（P<0.05），and a more significantly increase was observed in diabetic diet manager group（P<0.05）. No peripheral neuropathy and macroangiopathy were found in both groups. The incidence of diabetic retinopathy and diabetic nephropathy，and readmission rate in diabetic diet manager group were lower than those in the traditional group（P<0.05）. Conclusion　The intervention using the diabetes diet manager developed by us may be far superior to traditional health education in terms of improving self-care ability and glycemic control，as well as reducing complication incidence and readmission rate in empty nesters with type 2 diabetes and poor glycemic control，indicating that it has a high value of clinical application.

Key words: Diabetes mellitus, type 2；Aged；Self-made diabetes diet manager；Self-management；Blood glucose self-monitoring

摘要： 背景　现阶段，老年糖尿病患者普遍存在血糖控制不佳、治疗依从性差等情况。饮食与血糖控制情况息息相关，研究如何管理糖尿病患者的饮食对改善患者的预后具有重要意义。目的　观察自制糖尿病饮食管理器在空巢老年血糖控制不佳糖尿病患者中的应用效果。方法　回顾收集2018年2—10月在甘肃中医药大学第三附属医院接受治疗且完成随访的60例空巢老年血糖控制不佳糖尿病患者的病历资料，作为传统组；收集2019年2—10月在甘肃中医药大学第三附属医院接受治疗且完成随访的60例空巢老年血糖控制不佳糖尿病患者的病历资料，作为管理器组。传统组接受传统常规健康教育，管理器组接受自制糖尿病饮食管理器健康教育，均干预6个月。分别对比干预前、干预6个月后两组血糖、自我管理能力〔采用糖尿病自我管理行为量表（SDSCA）评估〕；观察并记录两组干预期间并发症发生情况及再入院情况。结果　干预6个月后，两组空腹血糖、餐后2 h血糖、糖化血红蛋白水平低于干预前，且管理器组均低于传统组，差异有统计学意义（P<0.05）；两组饮食自我管理、运动自我管理、血糖自我监测及按医嘱用药评分均优于干预前，且管理器组均优于传统组，差异有统计学意义（P<0.05）；两组均未发生周围神经和大血管病变，且管理器组糖尿病视网膜病变、糖尿病肾病发生率及再入院率均低于传统组，差异有统计学意义（P<0.05）。结论　基于自制糖尿病饮食管理器开展饮食健康教育在空巢老年血糖控制不佳糖尿病患者中的应用效果较好，可明显提高患者自我管理能力、改善患者血糖水平、降低并发症发生率及再入院率，临床应用价值高。

关键词: 糖尿病, 2型；老年人；自制糖尿病饮食管理器；自我管理；血糖自我监测