背景:糖尿病在全世界的發生率逐年增加,而糖尿病前期是發展成為糖尿病最主要的風險因子。糖尿病前期乃指空腹血糖異常及葡萄糖耐受不良者,若能給予糖尿病前期者生活型態的修正則可以預防或延緩糖尿病前期進展到糖尿病。然而糖尿病前期者沒有任何症狀,改變動機也較低,必須讓糖尿病前期者能自己發現問題,進而引發改變動機,方能展現行為的改變。而自我調節理論正是讓個案自我觀察、對自己的行為進行判斷,進而設定改變目標及計畫之理論,因此,本研究以自我調節理論為基礎,發展生活型態修正方案,期望能協助糖尿病前期者擁有更健康的生活型態。 目的:測試生活型態修正方案對糖尿病前期者糖尿病預防知識、飲食、身體活動量及生理指標之效應。 方法:本研究是前後測類實驗設計,於南台灣兩家醫院收集30位空腹血糖異常,且介於20~65歲之民眾,受試者以性別及身體質量指數作為配對條件,分配為實驗組15人及對照組15人,實驗組給予四週生活型態介入方案,所有受試者皆會給予一本糖尿病預防受測、一本自我調節手冊及一個計步器。前測(T0)收集受試者知識、飲食、身體活動及生理指標之資料,方案介入後(T1:第5週),進行知識、飲食及身體活動量的測量,方案介入後三個月(T2:第17週),再次進行知識、飲食、身體活動及生理指標之測量。資料經統計軟體JMP 8.0分析。 結果:組內效應中,實驗組組內在所有生理指標、知識、飲食及身體活動量之前後測差異平均值皆達到顯著差異(p< .05),對照組在所有結果測量皆未達顯著性差異。在組間效應方面,僅(T2-T0)在飲食行為上,實驗組改善顯著優於對照組(p= .013),在其他測量指標上則未達顯著差異。 結論:結果顯示透過自我調節所設立的生活型態方案可顯著改善實驗組健康行為及生理指標,並持續至方案後三個月,呈現其效應之延續效果。尤其在方案介入後三個月,實驗組在飲食行為的改變更優於對照組。
Abstract BACKGROUND: People with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), i.e. prediabetes, are at high risk of developing diabetes and other chronic disease. Lifestyle modification can prevent or delay the progression from prediabetes to diabetes. An effective lifestyle modification program can lead prediabetic people to have healthier diet and habits of physical activity. OBJECTIVE: To examine the effect of a 4-week lifestyle modification program on knowledge, behavior, and physiological indices: body mass index (BMI), fasting glucose, waistline, cholesterol, and triglyceride (TG). METHODS: This study was conducted between June 2011 and December 2011, at two hospitals in southern Taiwan. Thirty adults aged 20 and above with IFG were assigned into two groups: intervention group (n=15) and control group (n=15), according to their gender and BMI. The intervention group enrolled in a 4-week lifestyle modification program, including a face-to-face counseling session and twice-a-week telephone calls. The control group received usual care only. Every participant received a self-regulation handbook, a diabetes prevention handbook and a pedometer. Baseline measures on the primary outcomes (BMI, fasting glucose, waistline, cholesterol, TG) and secondary outcomes (knowledge of prediabetes, dietary behavior, and physical activity) were taken before the intervention. Measures of the secondary outcomes were repeated one month later (T1), then both the primary and secondary outcomes were repeated again three months later (T2). RESULTS: Significant differences before and after the intervention were found for the intervention group, including fasting glucose (mean= –3.80, SD=4.41 , p=.008), cholesterol (mean= –15.40 , SD=23.46 , p=.043), TG (mean= –52.93, SD=86.71 , p=.026), BMI (mean= –0.48, SD=0.84 , p=.035), waist circumference (mean= –2.04 , SD=3.14 , p=.026), knowledge (mean=1.87~1.93, SD=1.73~2.12, p=.001~.004), physical activity (mean=1442.03~1213.10, SD=2503.93~1525.96, p=.015~.005), and dietary behavior (mean=2.40~2.73, SD=2.82~2.69, p=.004~002). Dietary behavior (from T2–T0), the intervention group was significantly better than control group (mean=2.67, CI=0.61~4.72, p= .013), insignificant differences were found for other outcomes. CONCLUSION: The Lifestyle Modification Program appeared to be effective in improving knowledge, dietary behavior and physical activity in adults with IFG.