| Background:Type 2 diabetes is a group of metabolic diseases characterized by hyperglycemia,the main pathogenesis is caused by insufficient insulin secretion or impaired biological function,which will cause damage to all organs throughout the body,especially the most common microvascular damage,and related cardiovascular and cerebrovascular diseases will cause serious consequences to individuals and society,and bring a huge burden.In order to improve the comprehensive treatment of diabetes,the self-management of diabetes was increasingly prominent,However,the current management mode medical units was the main body,medical treatment and medicine was the primary means,and patients accepted management passively.The purpose of this study was to investigate the current status of self-management of diabetes,develop a more appropriate self-management program for specific populations in the future,and explore the effectiveness of ASCVD risk-based diabetes education in improving self-management of diabetes patients.Methods:A total of 250 T2DM patients were enrolled from the outpatients or inpatients in the department of endocrinology in the second affiliated hospital of Nanchang university from August 2018 to January 2019.All these patients signed informed consent for diabetes education.Baseline data and clinical data for ASCVD-related risk score were collected,and DM self-management questionnaire at the time of inclusion was completed.Thereafter,the patient visited our hospital on a monthly basis to receive ASCVD based diabetes education courses.Clinical data and DM self-management questionnaire were re-collected again after 6 months to evaluate the self-management.SPSS21.0 statistical software package was used for data analysis,t-test was used for group comparison,and chi-square test was used for hypothesis test.Results:1.Among the initial 250 patients with type 2 diabetes,242 completed the 6-month education course and the follow-up,including 130 males and 112 females.No significant difference was found between the gender(=2.005,p=0.046).The unqualified rate of HbA1c is 69%(167 patients),the unqualified rate of BMI is 48%(171 persons),The ASCVD high-risk population accounted for 93%(225 patients)of the total population.2.The scoring rate of diabetes self-management scale ranged from 28.5 to 82.4%,with an average of(57.24±9.97%),The proportion of those with poor self-management(<60%)was 60%(146 patients),those with qualified scores(60%?80%)were 31%(76 patients),and those with good scores(>80%)were 8%(20 patients).3.The changes in self-management status of diabetic patients before and after receiving the ASCVD based diabetes education courses were shown as follows:Eating habits:88(36.36%)vs 147(60.74%);medical compliance:121(50.0%)vs 158(65.29%);physical activity:59(24.38%)vs 89(36.78%);blood glucose monitoring:74(30.58%)vs 103(42.56%);foot self-examination:52(21.49%)vs 131(54.13%),and the different of all above were statistically significant by X2 test(p<0.05).4.The changes of relevant clinical indicators before and after the ASCVD based diabetes education courses were displayed as follows:reaching the glucose target:75(30%)vs 102(42.1%)(p<0.05);reaching the lipid target:143(59.1%)vs 168(69.4%)(p<0.05);number of smokers:68(28.1%)vs63(26%),(p=0.609).Conclusion:The self-management status of diabetic patients was poor,and the self-management level and clinical indicators of diabetic patients were improved after short-term ASCVD related risk education. |
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