自我血糖监测联合数字化血糖管理改善2型糖尿病患者血糖控制的作用探讨

目的探讨数字化血糖管理模式下糖尿病患者自我血糖监测(self-monitoring blood glucose, SMBG)进行血糖干预的有效性。方法门诊招募2型糖尿病患者60例，随机分为对照组(n=30)和干预组(n=30)，研究周期3个月。干预组患者需每日进行SMBG： 随访的第1周每日7次，其余周每日1次，并在随访的第1周末，以及接下来的3个月内，每2周回到医院进行面诊，同时研究护士将核对上传到网络云端的SMBG数据；而对照组患者则不规定SMBG次数与面诊频率，依旧按照其过往的就诊模式进行随访，但需在3个月随访期结束时完成一次医院面诊。结果在随访期末，除了体重指数(body mass index, BMI)，干预组患者的多项生化指标如腰臀比、空腹血糖、糖化血红蛋白、低密度脂蛋白、总胆固醇、甘油三酯、碱性磷酸酶和血尿素氮等均有显著下降(P<0.05)；而高密度脂蛋白水平则显著上升(P<0.05)。方差分析结果显示，血糖以及空腹血糖变异系数也都呈现出下降趋势。调查问卷结果显示，患者对于SMBG的认知有所改善，依从性也有所提高(P<0.05)；而对照组患者除了空腹血糖显著下降外，其余指标随访前后均无明显变化。结论数字化血糖管理和SMBG相结合，可以有效控制血糖，并且提高门诊患者在院外进行SMBG的意识和依从性，显著降低低血糖的发生风险。

Self-blood glucose monitoring with digital management improves blood glucose control in patients with type 2 diabetes

ObjectiveTo assess the efficacy and advantages of self-monitoring blood glucose(SMBG) with digital management in patients with type 2 diabetes mellitus(T2DM). MethodsSixty T2DM patients were randomly divided into the control group(n=30) and intervention group(n=30). In intervention group patients tested blood glucose 7 times per day in the first week, then once a day during the remaining weeks; the study nurse checked SMBG data and uploaded to the database; patients were followed up in the clinic at the end of the first week, and then every 2 weeks for total 3 months. In the control group patients were managed routinely and required for clinic visit at the end of the follow-up period. ResultsIn intervention group the WHR, FBG, HbA1C, LDL, TC, TG, ALP, BUN decreased; and HDL increased significantly at the end of the follow-up(all P<0.05). In addition,the SD-BG and FPG-CV trended downward throughout the study; the behavior and attitude towards SMBG of patients also improved(all P<0.05). In the control group, the FBG was decreased by the end of the study, while there were no significant changes in other parameters. ConclusionThe SMBG with digital management can improve the glucose control, change the attitude and behaviors towards SMBG of T2DM patients.