CAJ | 학술논문

目的探讨自我血糖监测对伴抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者降糖治疗的影响,以评估自我血糖监测是否适用于伴抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者.方法选取796例同一社区非胰岛素治疗的2型糖尿病患者,予以抑郁自评量表和焦虑自评量表自评,根据自评得分分为轻度抑郁、中重度抑郁、轻度焦虑、中重度焦虑、无情绪障碍,并根据血糖监测方式将每种情绪状态的患者分为自我血糖监测组和静脉血浆血糖监测组,随访16周.比较应用不同血糖监测方式的各组患者自行调整测血糖次数、自行调整降糖药物的比例及研究末糖化血红蛋白达标情况.结果伴中重度抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者,自我血糖监测组自行调整测血糖次数的比例、自行调整降糖药物的比例明显高于静脉血浆血糖监测组(P<0.05),自我血糖监测组的研究末糖化血红蛋白达标率明显低于静脉血浆血糖监测组(P<0.05).结论伴中重度抑郁或焦虑情绪的非胰岛素治疗的2型糖尿病患者使用自我血糖监测可因抑郁、焦虑情绪因素自行改变血糖监测和降糖治疗方案,影响患者的血糖达标,因此不适宜进行自我血糖监测.
목적 탐토자아혈당감측대반억욱혹초필정서적비이도소치료적2형당뇨병환자강당치료적영향,이평고자아혈당감측시부괄용우반억욱혹초필정서적비이도소치료적2형당뇨병환자.방법 선취796례동일사구비이도소치료적2형당뇨병환자,여이억욱자평량표화초필자평량표자평,근거자평득분분위경도억욱、중중도억욱、경도초필、중중도초필、무정서장애,병근거혈당감측방식장매충정서상태적환자분위자아혈당감측조화정맥혈장혈당감측조,수방16주.비교응용불동혈당감측방식적각조환자자행조정측혈당차수、자행조정강당약물적비례급연구말당화혈홍단백체표정황.결과 반중중도억욱혹초필정서적비이도소치료적2형당뇨병환자,자아혈당감측조자행조정측혈당차수적비례、자행조정강당약물적비례명현고우정맥혈장혈당감측조(P<0.05),자아혈당감측조적연구말당화혈홍단백체표솔명현저우정맥혈장혈당감측조(P<0.05).결론 반중중도억욱혹초필정서적비이도소치료적2형당뇨병환자사용자아혈당감측가인억욱、초필정서인소자행개변혈당감측화강당치료방안,영향환자적혈당체표,인차불괄의진행자아혈당감측.
Objective To study the effects of self-monitoring of blood glucose (SMBG) on antidiabetic treat-ment in non-insulin treated type 2 diabetes mellitus patients with depression or anxiety and evaluate whether SMBG is ap-plicable in type 2 diabetes mellitus patients with depression or anxiety.Methods A total of 796 cases of non-insulin treated type 2 diabetes mellitus patients from the same community medical center were enrolled.All subjects completed surveys with self-rating depression scale (SDS) and self-rating anxiety scale (SAS) .Patients were classified as mild depression,moderate to severe depression,and/or mild depression,moderate to severe anxiety,or no emotional disorder (ED) based on SDS and SAS scores.According to blood glucose monitoring methods,patients within each emotional sta-tus were randomly divided into SMBG group and venous plasma glucose monitoring (VPG) group.Patients were followed up for 16 weeks.The following outcomes were compared,frequency of self-adjustment of blood glucose measurement,percentage of patients with self-adjustment of antidiabetic drugs and percentage of patients reaching clinical HbA1c tar-get.Results In the moderate to severe depression or anxiety patients of the SMBG group,frequency of self-adjustment of blood glucose measurement and percentage of patients with self -adjustment of antidiabetic drugs were significantly higher than in the VPG group (P<0.05) .At the end of the investigation,the percentage of patients reaching clinical HbA1c target in the SMBG group was lower than in the VPG group (P<0.05).Conclusion SMBG is not applicable in non-insulin treated type 2 diabetes mellitus patients with moderate to severe depression or anxiety.These patients may al-ter blood glucose monitoring and antidiabetic treatment regimen without medical consults due to emotional factors of depres-sion or anxiety,which plays a negative role in reaching target blood glucose.