糖尿病自我管理教育对糖尿病患者血糖和炎性因子的影响

目的：探讨糖尿病自我管理教育对住院糖尿病患者血糖控制和炎性因子水平的影响。方法：2012年6月～2013年6月，我院内分泌科收治的168例糖尿病患者被随机分为自我管理教育组（自我管理组，88例）和常规健康教育组（常规管理组，80例）。自我管理组接受专职的糖尿病健康教育人员提供的自我管理教育课程，即AADE7^TM，包括健康饮食、积极活动、监测、服药、解决问题、健康心理应对、降低风险等7项，常规管理组则给予常规的糖尿病健康教育。测定干预前后血糖控制情况和髓过氧化物酶（MPO）、肿瘤坏死因子α（TNF-α）、细胞间粘附分子一1（ICAM-1）三种炎性因子水平变化。结果：干预后，两组患者的空腹血糖、餐后血糖和糖化血红蛋白水平较干预前均有显著下降（P均〈0．05），与常规管理组比较，自我管理组患者的空腹血糖（7．14±1．3）mmol／L比（6．0±1．1）mmol／L]、餐后血糖（9．5±1．6）mmol／L比（8．8±1．4）mmol／L]和糖化血红蛋白（7．9±1．5）％比（7．2±1．1）％]水平显著降低（P均〈0．05）；两组患者的炎性因子水平较干预前均有显著下降（P均〈20．05），与常规管理组比较，自我管理组患者的炎性因子水平显著降低TNF-α：（201．0±57．3）pg／ml比（100．7±49．2）pg／ml，ICAM-1：（25．2±3．6）ng／ml比（18．2±2．9）ng／m1]（P均〈0．05）。结论：专职的糖尿病健康教育人员提供的自我管理教育对糖尿病患者的血糖控制及降低炎性因子水平效果优于常规的糖尿病健康教育，提示可改善β细胞功能及减轻胰岛素抵抗。

Influence of diabetic self-management education on blood glucose control and inflammatory factor levels in inpatients with diabetes mellitus

Objective： To explore the influence of diabetic self-management education on blood glucose control and inflammatory factor levels in inpatients with diabetes mellitus （DM）. Methods： A total of 168 DM patients, who hospitalized in department of endocrinology in 163rd hospital of Chinese PLA from Jun 2012 to Jun 2013, were randomly divided into self-management education group （self-management group, n = 88） and routine health education group （routine management group, n = 80）. Self-management group received self-management education course namely AADE^7TM, provided by full-time DM health education staff, including healthy eating, being active, monitoring, taking medication, problem solving, healthy coping and reducing risks, while routine management group received routine DM health necrosis factor-α （TNF-α） education. Blood glucose control, changes of levels of myeloperoxidase （MPO）, tumor and intercellular adhesion molecule-1 （ICAM-1） were examined before and after intervention. Results： Compared with before intervention, there were significant reductions in levels of fasting blood glucose （FBG）, postprandial blood glucose （PBG） and glycosylated hemoglobin （HbAlc） in both groups after interventions （P〈0.05 all）. Compared with routine management group, there were significant reductions in levels of FBG （7. 1±1.3） mmol/L vs. （6.0 ±1.1） mmol/L], PBG （9.5 ± 1.6） mmol/L vs. （8.8± 1.4） mmol/L] and HbA1c （7.9 ±1.5） % vs. （7.2 ± 1.1） %] in self-management group, P〈0.05 all. Before discharge, there were significant de- crease in inflammatory factor levels in both groups compared with before intervention （P〈0.05 all）. Compared with routine management group after intervention, there were significant decrease in inflammatory factor levels TNF-α： （201.0 ±57.3） pg/ml vs. （100.7 ±49.2） pg/ml, ICAM-1; （25.2 ± 3.6） ng/ml vs. （18.2 ± 2.9） ng/ml]in self-management group, P ~ O. 05 both. Conclusion.. Self-management ed