糖尿病APP用于门诊2型糖尿病患者健康管理效果探讨

目的探讨糖尿病APP管理模式对2型糖尿病患者血糖控制以及自我管理的效果。方法将189例门诊初始使用胰岛素治疗的2型糖尿病患者随机分为对照组94例与观察组95例,在教会患者胰岛素注射方法的基础上,对照组给予常规健康教育指导,观察组应用糖尿病APP管理,连续3个月后评价效果。结果观察组空腹血糖、餐后2h血糖及糖化血红蛋白改善程度显著优于对照组(均P0.01),自我管理行为能力得分显著高于对照组(P0.05,P0.01)。结论对门诊2型糖尿病患者采用糖尿病APP进行健康管理可提高患者自我管理能力,从而较好地控制血糖水平。     

记录糖尿病日历对妊娠期糖尿病患者自我管理行为及血糖的影响

目的探讨记录"糖尿病日历"对妊娠期糖尿病患者自我管理行为及血糖的影响。方法将159例门诊妊娠期糖尿病患者按诊断先后顺序分为对照组78例,干预组81例,对照组接受常规自我管理教育,干预组接受自我管理教育后指导患者记录"糖尿病日历"。干预1个月后比较两组自我管理行为评分和血糖水平。结果 1个月后,干预组自我管理行为中饮食依从性、运动、自我血糖监测问题得分显著优于对照组(P0.05,P0.01),餐后2h血糖显著低于对照组(P0.01)。结论记录"糖尿病日历"可提高妊娠期糖尿病患者的自我管理行为,降低其血糖水平。     

老年早期糖尿病肾病患者的多学科分阶段管理

目的 提高老年早期糖尿病患者自我管理能力,延缓疾病进展.方法 将60例老年早期糖尿病肾病患者随机分为对照组和观察组各30例.对照组实施常规护理,观察组采用多学科分阶段管理,干预3个月后评价效果.结果 干预后观察组空腹血糖、餐后2h血糖、糖化血红蛋白、尿蛋白/肌酐比值及肾小球滤过率显著优于对照组,自我管理能力、生活质量及社会支持度显著高于对照组,抑郁得分显著低于对照组(均P＜0.01).结论 多学科分阶段管理可显著改善老年早期糖尿病肾病患者疾病相关指标,提高自我管理能力,从而改善抑郁情绪,提高生活质量.     

自我管理干预对糖尿病患者心理及行为的作用

目的 探讨自我管理疗法对改善糖尿病患者心理状况及行为的效果.方法 将60例糖尿病患者随机分为对照组(30例)和干预组(30例),对照组采用常规护理,干预组进行自我管理疗法干预.干预前后分别采用症状自评量表和糖尿病患者行为评估表对两组患者心理状况和行为状态进行评定.结果 干预后两组除偏执和其他因子外,其余因子评分比较,差异有统计学意义(均P＜0.05);干预后两组患者在血糖控制、复查时间的掌握、坚持运动锻炼、戒烟、戒酒行为比较,差异有统计学意义(P＜0.05,P＜0.01).结论 自我管理疗法对提高糖尿病患者的心理健康水平,增加其健康行为有积极的作用.     

老年糖尿病患者自我效能干预方案的实施

目的评价老年糖尿病患者自我效能干预方案的实施效果。方法采用随机数字表法将96例老年2型糖尿病患者随机分为两组各48例,对照组给予常规护理与健康教育,观察组在对照组基础上实施自我效能干预,干预前后分别应用糖尿病心理痛苦量表、糖尿病自我管理行为量表对患者进行测评。结果干预后观察组自我管理行为得分显著高于对照组,心理痛苦得分显著低于对照组(均P0.01)。结论对老年糖尿病患者实施自我效能干预能够明显缓解心理痛苦,提高自我管理行为水平,有利于老年糖尿病患者病情控制。     

ADOPT模式护理干预在妊娠期糖尿病患者中的应用

目的 探讨ADOPT模式护理干预在妊娠期糖尿病患者中的应用效果。方法 选取妇产科门诊就诊的120例妊娠期糖尿病患者,按随机数字表法分为对照组和观察组各60例。对照组实施常规护理干预及健康指导,观察组在对照组基础上实施ADOPT模式护理干预,持续8周。对比两组干预前后糖尿病自我管理行为得分、血糖控制水平及妊娠结局。结果 干预后观察组糖尿病自我管理行为得分显著高于对照组（P＜0.01）,空腹血糖、餐后2 h血糖及糖化血红蛋白显著低于对照组（均P＜0.01）;观察组妊娠高血压、羊水过多、巨大儿发生率显著低于对照组（均P＜0.05）。结论 对妊娠期糖尿病患者实施ADOPT模式护理干预,能够提高自我管理行为水平,有效控制血糖水平,并改善患者妊娠结局。     

心脏移植术后糖尿病患者的自我管理干预

目的探讨自我管理干预对心脏移植术后新生糖尿病患者血糖与自我管理能力的影响。方法将64例心脏移植术后糖尿病患者按住院时间段分为对照组和观察组各32例,对照组给予常规护理,观察组实施情绪、角色和行为自我管理干预。结果观察组出院3个月血糖控制、糖尿病知识及自我管理行为评分显著优于对照组(均P0.05)。结论对心脏移植术后糖尿病患者实施自我管理干预能提高患者自我管理行为,有效控制血糖。     

群组管理模式在社区老年2型糖尿病患者中的应用

目的探讨群组管理模式在社区老年2型糖尿病患者中的应用效果,为开展社区糖尿病健康管理提供依据。方法将老年2型糖尿病患者109例,按照所属小区分为观察组(55例)和对照组(54例)。对照组按照社区慢性病常规管理模式进行健康管理;观察组实施群组管理模式,每月1次,干预5个月。比较两组干预前后糖尿病知识、自我管理及糖化血红蛋白(HbA1c)的变化。结果干预后两组糖尿病知识及自我管理总分较干预前均增加,观察组显著优于对照组(均P0.05)。两组干预后HbA1c比较,差异无统计学意义(P0.05),但6个月随访时,观察组HbA1c下降幅度(1.31%)大于对照组(0.96%)。结论群组管理模式可显著提高社区老年2型糖尿病患者的疾病相关知识水平和自我管理水平,有利于患者血糖控制。     

2型糖尿病患者基础胰岛素剂量自我调整方案的随访管理

目的评价2型糖尿病患者基础胰岛素剂量自我调整方案的随访管理效果。方法将849例2型糖尿病患者按住院时间分为对照组(423例)和观察组(426例)。对照组采用由医生门诊调整胰岛素剂量的常规方案,观察组由糖尿病专科护士依据医生制定的血糖调整方案卡对患者自我调整胰岛素剂量进行全程随访管理。干预12周后比较两组血糖指标、糖尿病知识水平、授权能力、自我管理能力。结果观察组血糖控制水平显著优于对照组(P0.05),两组低血糖发生率差异无统计学意义(P0.05);观察组糖尿病知识水平、授权能力、自我管理能力显著优于对照组(P0.05,P0.01)。结论糖尿病专科护士对患者自我调整基础胰岛素剂量进行全程随访管理在血糖控制方面安全有效,且能提高患者自我管理能力和授权能力。     

多学科团队协同延续护理在糖尿病视网膜病变患者中的应用

目的观察多学科糖尿病照护团队协同延续护理模式在糖尿病视网膜病变患者中的应用效果。方法将160例2型糖尿病视网膜病变患者按照入院时间分为对照组与观察组各80例。对照组按常规糖尿病视网膜病变管理模式,观察组采用多学科糖尿病照护团队协同延续护理模式。干预前及干预后6个月、1年测量患者血糖,并评估患者糖尿病视网膜病变防治知识知晓率,患者生活质量、遵医行为和糖尿病自我管理行为,出院后再入院行眼科手术或调节血糖的例数。结果干预后观察组患者空腹血糖、餐后2 h血糖、糖化血红蛋白控制水平,知识掌握情况、低视力者生活质量,遵医行为和糖尿病自我管理行为显著优于对照组(P0.05,P0.01)。结论多学科糖尿病照护团队协同延续护理模式可改善2型糖尿病患者血糖水平,提高低视力者生活质量、遵医行为和糖尿病自我管理行为,延缓糖尿病视网膜病变进展。     

Nephropathy in Type II diabetes

Summary: The incidence and prevalence of end-stage renal failure due to renal involvement in patients with type II diabetes has increased in the Western world and in Asia. Interesting differences of prevalence of this disease are found between nations. the reasons for the increase in the frequency of nephropathy in type II diabetes include: (i) an increasing prevalence of type II diabetes; (ii) ageing of the population; and (iii) improved survival of patients with type II diabetes. Today patients frequently live long enough to develop diabetic nephropathy. In contrast with previous opinion, no major differences in renal involvement is found between type I and type II diabetes. This applies to renal haemodynamics as well as renal histology, although non-specific changes, presumably of an ischaemic nature are more frequently found in patients with type II diabetes. the renal risk appears to be similar in type II diabetes (i.e. cumulative prevalence of proteinuria and rate of progression to renal failure).     

Genetics of diabetes

Diabetes mellitus is a complicated disease characterized by a complex interplay of genetic, epigenetic, and environmental variables. It is one of the world's fastest-growing diseases, with 783 million adults expected to be affected by 2045. Devastating macrovascular consequences (cerebrovascular disease, cardiovascular disease, and peripheral vascular disease) and microvascular complications (like retinopathy, nephropathy, and neuropathy) increase mortality, blindness, kidney failure, and overall quality of life in individuals with diabetes. Clinical risk factors and glycemic management alone cannot predict the development of vascular problems; multiple genetic investigations have revealed a clear hereditary component to both diabetes and its related complications. In the twenty-first century, technological advancements (genome-wide association studies, next-generation sequencing, and exome-sequencing) have led to the identification of genetic variants associated with diabetes, however, these variants can only explain a small proportion of the total heritability of the condition. In this review, we address some of the likely explanations for this "missing heritability", for diabetes such as the significance of uncommon variants, gene-environment interactions, and epigenetics. Current discoveries clinical value, management of diabetes, and future research directions are also discussed.     

新诊断糖尿病住院患者糖尿病痛苦现状及影响因素研究

目的调查新诊断糖尿病住院患者(新诊断患者)的糖尿病痛苦现状,探讨其影响因素,为开展针对性干预提供参考。方法采用领悟社会支持量表、医学应对方式问卷、中文版糖尿病痛苦量表对100例新诊断患者进行问卷调查。结果新诊断患者的糖尿病痛苦总分1.88±0.71;35.0%存在糖尿病痛苦;糖尿病痛苦总分及各维度得分与领悟社会支持总分及各维度呈负相关,与屈服、回避因子呈正相关(P<0.05,P<0.01);屈服应对方式、领悟社会支持和住院时间是患者糖尿病痛苦的影响因素(调整R2=0.414)。结论新诊断患者糖尿病痛苦发生率高,受屈服应对方式、领悟社会支持及住院时间的影响,医护人员应及时评估和引导患者积极应对,以减少其糖尿病痛苦。     

Trends in prevalence of diabetes in Asian countries

Diabetes is a major lifestyle disorder,the prevalence of which is increasing globally.Asian countries contribute to more than 60% of the world’s diabetic population as the prevalence of diabetes is increasing in these countries.Socio-economic growth and industrialization are rapidly occurring in many of these countries.The urban-rural divide in prevalence is narrowing as urbanization is spreading widely,adversely affecting the lifestyle of populations.Asians have a strong ethnic and genetic predisposition for diabetes and have lower thresholds for the environmental risk factors.As a result,they develop diabetes at a younger age and at a lower body mass index and waist circumference when compared with the Western population.The adverse effect of physical inactivity and fatty food are manifested as the increasing rate of overweightness and obesity,even among children.The health care budgets for the disease management are meager and the health care outcome is far from the optimum.As a result,complications of diabetes are common and the economic burden is very high,especially among the poor strata of the society.National endeavors are urgently needed for early diagnosis,effective management and for primary prevention of diabetes.This editorial aims to highlight the rising trend in prevalence of diabetes in Asia,its causative factors and the urgent need to implement national strategies for primary prevention of type 2 diabetes.     

糖尿病患者扳机指的特点及治疗

目的 了解糖尿病人扳机指的发病特点,并对类固醇激素鞘内注射、手术这两种治疗方法的远期疗效予以评价。方法 对63例糖尿病人142个扳机指,并以63例非糖尿病人80个扳机指作为对照组进行回顾性研究。结果 对照组类固醇激素鞘内注射治愈率明显高于糖尿病组,有显著性差异;糖尿病组中非胰岛素依赖型糖尿病(NIDDM)患者局部注射及手术治愈率均高于胰岛素依赖型糖尿病(IDDM)患者,但无显著性差异;对照组手术治愈率高于糖尿病组,无显著性差异。糖尿病组多指受累发生率及弥漫型扳机指发生率均高于对照组,有显著性差异。结论 糖尿病人特别是IDDM病人扳机指比非糖尿病人扳机指治疗难度大,多指受累及需手术缓解症状的可能性大。     

Regional anaesthesia in patients with diabetes

Diabetes is the most common metabolic condition worldwide and about 20% of surgical patients will have this condition. It is a major risk-factor for worse outcomes after surgery including mortality; infective and non-infective complications; and increased length of stay. However, diabetes is a modifiable risk-factor, and programs to improve medical management have the potential to reduce peri-operative complications and the risk of harm. Regional anaesthesia has well-documented benefits in promoting the restoration of function but there are legitimate concerns that the incidence of complications of regional anaesthesia in patients with diabetes is higher. The aim of this review is to explore in detail the various potential advantages and disadvantages of regional anaesthesia in patients with diabetes. This, in turn, will allow practitioners to undertake more informed shared decision-making and potentially modify their anaesthetic technique for patients with diabetes.