Jln Medical College, Ajmer.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
Diabetes mellitus (DM) is a chronic metabolic disease with debilitating complications. Diabetic Patients should follow self-care activities like healthy diet, physical activity, self-monitoring of blood glucose, treatment compliance in order to achieve good glycaemic control, control the progression of the disease, reduce complications, and quality of life improvement. We aimed to assess the effect of diabetes self-management education program on HbA1c levels in patients with diabetes.
The present study was conducted at a tertiary care centre in central Rajasthan after written consent. Adults with 18 years and above age with Diabetes were included. Patients who refused to give consent, critically ill patients, pregnant females, patients with severe cognitive impairment and whose HbA1c targets were achieved were excluded. It was an open label randomised control study. Simple randomization was done. Cases were then provided with Diabetes self-management education (DSME). The information was provided in local language. One twenty patients were studied during the period from 01/12/2020 to 1/12/2021. All patients underwent complete history taking, physical examination, routine laboratory examination and HbA1c levels. After providing the cases with DSME, all patients were followed up at 6 months. HbA1c level was measured again at 6 months. Pre and post test data of both control and intervention arm were collected. Data was analysed using Statistical package for social science (SPSS) software ver. 2021 and student t test and chi square tests were applied.
The mean age of participants was 49.07 years, male patients represented 57.5%. About two-thirds were from urban areas. 59.16% were diabetics for 5-10 years. After the DSME program, there was a statistically significant decrease in HbA1c level in intervention group compared to controls (p value<0.05). 56% used oral hypoglycaemic agents, 24% used insulin and 20% used combination therapy of oral hypoglycaemic agents and insulin. Hypertension was the most common co-morbidity followed by dyslipidaemia among patients. There was no significant difference in age, gender and duration of diabetes between the two groups.
DSME plays a significant role in enabling patients to undertake self-management activities to combat their diabetes-related complications and potential premature deaths.
DSME may prevent the onset and the progression of diabetic complications. It is important and promising to raise the self-management capacity of Type 2 Diabetes mellitus patients in low-resource settings.
评估糖尿病自我管理教育计划对糖尿病患者糖化血红蛋白(HbA1c)水平的影响。
本研究在拉贾斯坦邦中部的一家三级护理中心进行,患者签署书面知情同意书后纳入研究。纳入年龄 18 岁及以上的成年糖尿病患者。排除拒绝签署知情同意书、病情危重、妊娠女性、严重认知障碍且 HbA1c 目标已达到的患者。这是一项开放标签的随机对照研究。采用简单随机化。然后为病例提供糖尿病自我管理教育(DSME)。以当地语言提供信息。在 2020 年 12 月 1 日至 2021 年 12 月 1 日期间,研究了 20 名患者。所有患者均接受完整的病史采集、体格检查、常规实验室检查和 HbA1c 水平检测。为病例提供 DSME 后,所有患者在 6 个月时进行随访。再次测量 6 个月时的 HbA1c 水平。收集对照组和干预组的预测试和后测试数据。使用统计软件包(SPSS)软件 2021 版和学生 t 检验和卡方检验进行数据分析。
参与者的平均年龄为 49.07 岁,男性患者占 57.5%。大约三分之二来自城市地区。59.16%的患者糖尿病病程为 5-10 年。在 DSME 计划后,干预组的 HbA1c 水平与对照组相比有统计学显著降低(p 值<0.05)。56%的患者使用口服降糖药,24%的患者使用胰岛素,20%的患者使用口服降糖药和胰岛素联合治疗。高血压是最常见的合并症,其次是血脂异常。两组间年龄、性别和糖尿病病程无显著差异。
DSME 可使患者开展自我管理活动,防治糖尿病相关并发症和潜在的过早死亡。
DSME 可能预防糖尿病并发症的发生和进展。提高资源匮乏环境下 2 型糖尿病患者的自我管理能力非常重要且有前景。