以系統性文獻回顧生活型態探討糖尿病前期的介入方案及其國內職場健康促進運用現況

Applying Lifestyle Modification Intervention to People with Prediabetes for Systematic Review & Meta-analysis: The Practice of Workplace Health Promotion in Taiwan

何林楨(Lin-Chen, Ho) ； 蘇文麟(Wen-Lin Su) ； 鐘雪文(Hsueh-Wen Chung)

《中華職業醫學雜誌》 27卷1期 (2020/01) Pp. 1-7

摘要

背景：糖尿病前期為日後發展成糖尿病的重要因子，糖尿病前期者常可藉由生活型態的調整，降低血糖、體重及降低糖尿病的發生率。目前我國政策僅提供員工體檢，缺乏對血糖過高個案給予完整說明及後續追蹤管理。本研究以系統性文獻探討糖尿病前期者接受生活型態方案之成效，並依據其結果以國內職場現況提供健康照護建議，期望能提供未來糖尿病前期者在職場健康照護模式之參考。方法：搜尋三個英文資料庫（Medline, PubMed, Cochrane Library）及一個中文資料庫（CEPS），文章型態著重於系統性文獻回顧及統合性分析，針對符合的文獻進行評析。結果：總共搜尋出404篇文獻，根據納入及排除條件，最後篩選出21篇。所有研究皆指出糖尿病前期者的介入方案需包含遵從健康飲食原則及每週至少150分鐘中度有氧活動，其方案內容可有效改善血糖、體重及HbA1c，其中個案管理為維持個案動機的重要策略。結論:在所有針對糖尿病前期者的生活型態方案中，以美國糖尿病學會所提出的糖尿病預防計畫（Diabetes Prevent Program; DPP）應是策略較為清楚且可被運用，該方案強調個案管理的概念，但國內職場健康促進缺乏個案管理的重要內涵，需由專任的職場健康促進人員整合資源以提供個案管理，考量在醫療財源有限的情況下，未來或許可藉由網路應用程式、行動程式及遠距醫療等工具輔助職場健康促進人員管理職場員工的健康。

關鍵字

糖尿病前期 ； 生活型態 ； 職場

並列摘要

Background: Prediabetes is an important risk factor for diabetes. Lifestyle modification intervention could decrease blood sugar and body weight, and prevent later occurrence of diabetes. The problem with the policy of occupational medicine in Taiwan is that there are not enough strategies to explain negative physical examination results and there is a lack of professionals to handle case management in individuals with prediabetes. In our study, the objective is to explain the lifestyle modification program to people with prediabetes for systematic review, to analyze the practice of workplace health promotion in Taiwan, and to make suggestions to practitioners on how that can improve it. Material and methods: Three English (Medline, PubMed, and Cochrane Library) and one Chinese (CEPS) databases were searched for information to aid in this research report. The focus of the articles found were not only on systematic review, but also on meta-analysis. All articles have also been previously published elsewhere in credible journals. The findings of these articles have been validated and critically appraised by a number of scholars. Results: An initially 404 articles were identified. After filtering based on inclusion criteria and exclusion duplicates, the authors selected the remaining 21 articles that contained either a systematic review or meta-analysis for further analysis. All 21 studies supported the relevance of the lifestyle modification program which includes an individual partaking in healthier foods and regular exercise. They also supported the fact that the lifestyle modification program can aid in decreasing fasting plasma glucose, body weight, HbA1c. Conclusions: The Diabetes Prevention Program (DDP) for prediabetes should be one of the more clear strategies that can be applied. However, the lack of professionals to handle case management in the domestic workplace health promotion is a problem because it requires a full-scale workplace health promotion staff to integrate resources and to aid cases. Management through tools such as web applications, mobile programs and telemedicine can be utilized in cases where there are limited medical resources. Such management tools may be heavily used in the future to assist in the health management of workplace health promotion personnel.

並列關鍵字

prediabetes ； lifestyle ； workplace