以病人為中心之第二型糖尿病血糖管理決策循環

Decision Cycle for Patient-Centered Glycemic Management in Type 2 Diabetes

徐慧君(Hui-Chun HSU) ； 李洮俊(Yau-Jiunn LEE) ； 王瑞霞(Ruey-Hsia WANG)

《護理雜誌》 66卷6期 (2019/12) Pp. 5-12

https://doi.org/10.6224/JN.201912_66(6).02

摘要

第2型糖尿病病人有賴有效的血糖管理才能達到預防併發症並維持生活品質的長期目標。美國糖尿病學會（American Diabetes Association）與歐洲糖尿病學會（European Association for the Study of Diabetes）在2018年的共同聲明中，建議採用以病人為中心的決策循環作為第2型糖尿病病人血糖管理的模式。本文介紹闡述以病人為中心的第2型糖尿病血糖管理決策循環的7個步驟，包括（1）評估病人的主要特質，（2）考量會影響治療選擇的特殊因素，（3）以共享決策方式擬定糖尿病自我管理教育支持計畫，（4）同意管理計畫，（5）執行管理計畫，（6）持續監測與支持，（7）檢視與同意管理計畫。健康專業人員可運用此7個步驟協助第2型糖尿病病人達到最佳的血糖管理。

關鍵字

第2型糖尿病 ； 血糖管理 ； 病人為中心 ； 決策循環

並列摘要

Effective glycemic control is crucial to achieving the ultimate goal of preventing complications and optimizing quality of life in patients with Type 2 diabetes. The American Diabetes Association and European Association for the Study of Diabetes recommend using the Decision Cycle for Patient- Centered Glycaemic Management as a model for caring for patients with Type 2 diabetes. This article describes the seven steps of this model. These steps are: (1) Assess key patient characteristics; (2) Consider specific factors that impact choice of treatment; (3) Shared decision-making to create a diabetes self-management education support plan; (4) Agree on a management plan; (5) Implement management plan; (6) Conduct regular monitoring and support; and (7) Review and agree on the management plan. Healthcare providers could apply these seven steps to help patients with Type 2 diabetes achieve optimal glycaemic management.

並列關鍵字

type 2 diabetes ； glycaemic management ； patient-centered ； decision cycle

參考文獻

American Diabetes Association. (2018). 9. Cardiovascular disease and risk management: Standards of medical care in diabetes-2018. Diabetes Care, 41(1, Suppl.), S86‡S104. https://doi.org/10.2337/dc18-S009

American Diabetes Association. (2019a). 4. Comprehensive medical evaluation and assessment of comorbidities: Standards of medical care in diabetes-2019. Diabetes Care, 42(1, Suppl.), S34–S45. https://doi.org/10.2337/dc19-S004

American Diabetes Association. (2019b). 5. Lifestyle management: Standards of medical care in diabetes-2019. Diabetes Care, 42(1, Suppl.), S46–S60. https://doi.org/10.2337/dc19-S005

American Diabetes Association. (2019c). 6. Glycemic targets: Standards of medical care in diabetes-2019. Diabetes Care, 42(1, Suppl.), S61-S70. https://doi.org/10.2337/dc19-S006

American Diabetes Association. (2019d). 9. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes-2019. Diabetes Care, 42(1, Suppl.), S90–S102. https://doi.org/10.2337/dc19-S009