電話提醒對第2型糖尿病人營養衛教完成率與血糖控制成效探討

Effectiveness of Telephone Reminders in Improving Nutrition Education Completion Rate and Glycemic Control among Patients with Type 2 Diabetes

劉金華(Chin-Hua Liu) ； 童慧珊(Hui-Shan Tung) ； 陳嘉珮(Chia-Pei Chen) ； 許美雅(Mei-Ya Hsu) ； 謝清川(Ching-Chuan Hsieh)

《臺灣膳食營養學雜誌》 8卷2期 (2016/12) Pp. 1-12

https://doi.org/10.6709/TJD.2016.0802.01

摘要

糖尿病歷年均位居臺灣十大死因前五名，且其人口數及死亡率皆逐年攀升。現行糖尿病照護網是由醫療團隊提供完整診療與照護，以控制糖尿病病況，但現況卻常因病人未定期接受飲食衛教及返診而影響照護品質與病情控制。本研究利用介入性研究，募集民國102年4月至7月於營養門診並加入糖尿病照護網之第2型糖尿病人。介入組在參加研究後第3、6、9、12個月由營養師於回診前電話提醒受試者須回營養門診接受衛教，對照組則不進行電話提醒。研究期間記錄受試者基本資料、疾病史、體重，並分析病人空腹血糖、糖化血色素、肌酸酐及血脂質。總招募244人，完成試驗人數為138人（介入組71人、對照組67人），結果顯示介入組在第3、6、12個月空腹血糖顯著低於基線空腹血糖，二組在第3、6、12個月糖化血色素皆顯著低於基線糖化血色素，血脂質部分，二組於第12個月總膽固醇及低密度脂蛋白膽固醇皆顯著低於基線。分析在同一時間點二組體重、身體質量指數、空腹血糖及糖化血色素則皆無統計差異。進一步以接受營養衛教次數分組，發現於追蹤期間接受3-4次衛教組之血糖濃度顯著低於接受1-2次衛教組。總結：利用電訪提醒確實能增加飲食衛教次數，並可能有助於空腹血糖下降。

關鍵字

糖尿病 ； 電話提醒 ； 血糖控制

並列摘要

Diabetes has been consistently ranked in the top five causes of death in Taiwan. In addition, the death toll and mortality rate for diabetes have continued to rise annually. The current shared care networks for controlling diabetes involve teams that provide services such as patient examinations, tests, and health education. However, the care quality in such schemes is undermined by patients who have not received healthy diet education or follow-up examinations regularly. Patients with type 2 diabetes who were aged ≥ 20 years and had joined a diabetes shared-care program were recruited at the nutrition outpatient department of a regional teaching hospital from April to July 2013. The experiment spanned 1 year. A nutritionist phoned intervention group participants for reminding them to visit the hospital to receive health education at 3, 6, 9, and 12 months after the start of the experiment. By contrast, no calls were made to remind control participants. Data of the demographic characteristics, body weight, and levels of fasting blood glucose, glycated hemoglobin (HbA1c), creatinine, and blood lipids were collected during the experimental period. A total of 244 participants were recruited; however, only 138 (71 and 67 of whom were from the intervention and control groups, respectively) completed this study. In the intervention group, the fasting blood sugar levels at 3, 6, and 12 months were significantly lower than those at baseline (p ＜ 0.05). In both groups, HbA1c levels at 3, 6, and 12 months were significantly lower than those at baseline (p ＜ 0.05), and total cholesterol and low-density lipoprotein cholesterol levels at 12 months were significantly lower than those at baseline (p ＜ 0.05). An analysis of the body weight, body mass index, and fasting blood sugar and glycated hemoglobin levels at different time points during the experiment period revealed no significant differences between the groups (p ＞ 0.05). Regarding the number of dietary education sessions and changes in fasting blood sugar levels, fasting blood glucose were significantly decreased in patients who received 3-4 dietary education sessions compared with those who received only 1-2 sessions. Thus, we conclude that telephonic reminding may be beneficial in improving fasting blood glucose.

並列關鍵字

diabetes ； telephone reminders ； diabetes control