Development of a diabetic support system

目的探讨专家对2型糖尿病患者血糖控制和生活质量的影响。研究设计与方法研究对象为2型糖尿病患者6个月以上未接受胰岛素治疗的患者。干预措施是使用加速计进行体力活动和自我监测血糖，为期6个月。受试者每月接受一次或两次采访，并通过邮件或电话传达有关体力活动和血糖控制的建议。结果21例患者，男18例，女3例，平均年龄50.8岁，平均病程8.6年。自我监测血糖水平发现，非胰岛素治疗的2型糖尿病患者6个月后血糖控制(HbAlc)显著改善(7.58±1.08%vs.7.21±0.95%，P=0.049)。在研究结束时，DTSQ评分低于基线(21.9±6.2比24.0±3.6，p=0.041)。然而，两组的付费得分(50.0±10.6比47.6±13.6，p=.382)无显著差异。6个月平均每天步行9000步。结论研究人员及时与受试者分享有关体力活动和血糖控制的生活方式建议。通过接受专家的建议和观察，受试者获得了安全感，并能够坚持计划。

Objective To clarify the effect on glycaemic control and QOL of advice and observation of a specialist for patients with type 2 diabetes.Research design and methods The subjects were patients who had suffered type 2 diabetes for over 6 months but had not received insulin. The interventions were physical activity using an accelerometer and SMBG (Self Monitoring Blood Glucose) for 6 months. The subjects were interviewed and advice about physical activity and glycaemic controlcommunicated by mail or telephone once or twice a month. To examine whether recognition of glucose level and activity influenced behavioral changes, DTSQ (Diabetes Treatment satisfaction Questionnaire) and PAID (Problem Area in Diabetes Survey) were administered at baseline and after 6 months.Results Twenty-one patient, 18 males and 3 females, mean age: 50.8years, mean duration of diabetes 8.6 years, completed the programme. A significant improvement in glycaemic control (HbAlc) was found after 6 months in patients withnon-insulin treated type 2 diabetes using self monitoring of blood glucose levels (7.58?}1.08% vs.7.21?}0.95%, p=.049). At the end of the study, DTSQ score was lower than at baseline (21.9?}6.2 vs.24.0?}3.6, p=.041). However, there was nosignificant difference in PAID scores (50.0?}10.6 vs.47.6?}13.6, p=.382). Average number of steps walked per day during the six months was 9000.Conclusion The researcher shared timely life style advice about physical activity and glycaemic control with the subjects. By receiving the advice and observation from a specialist, the subjects gained a sense of security and were able to adhere to the programme.