第2型糖尿病病人醫囑遵從與主客觀睡眠品質對血糖控制相關性之研究

郭曉玲

doi:10.6834/CSMU.2012.00091

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第2型糖尿病病人醫囑遵從與主客觀睡眠品質對血糖控制相關性之研究

Behavial Compliance and Quality of Sleep for Glycemic Control in Patients With Type 2 Diabetes

郭曉玲 , Masters　　Advisor：廖玟君　　

繁體中文 DOI： 10.6834/CSMU.2012.00091

第2型糖尿病；醫囑遵從性；主客觀睡眠品質；血糖控制； diabetes compliance ； glycemic control ； subjective and objective sleep quality ； type 2 diabetes

Abstract │ Reference (150) │ Altmetrics

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Type 2 diabetes induced health problems threaten our health. The purpose of this study was to explore behavioral compliance (medication, diet, and exercise), and  subjective and objective sleep quality on glycemic control in patients with type 2 diabetes. A purpose sampling and cross-sectional design was used in this study. Subjects were recruited from the Endocrinology and Metabolism outpatient clinics of a medical center. A total of 65 participant completed this study. The Pittsburg Sleep Quality Index (PSQI) and 72-hour of wrist actigraphy were used to assess subjective sleep quality and objective sleep patterns, respectively. The Diabetic Compliance Questionnaire was used to assess patient compliance in medication, diet, and exercise. Glycemic control was assessed by the fasting sugar (AC sugar) and hemoglobin A1c (HbA1c). SPSS 17.0 software package was used to for statistical analysis.
     Results show that 83.1% of diabetic patients had poor glycermic control (HbA1c> 6.5%) with an average of 8.1 ± 1.8% in HbA1c and 165.5 ± 47.7mg/dl in AC sugar. About half (44.6%) of participants had poor sleep quality (PSQI> 5) with a mean PSQI score of 6.8 ± 4.5. Nocturia is the main reason to disturb sleep. Objective sleep measured from wrist actigraphy show that participants had 6.7 hours of total sleep time, 75.7% of sleep efficiency, 33.2 minutes of sleep latency (SL), and 65.5 minutes of wakening after sleep onset (WASO), which indicate poor sleep quality. In diabetes compliance, the highest score was medication (3.8) followed by diet control (3.3) and exercise (2.5), indicate the worst compliance in exercise. Correlation result shows that the better medication compliance, the better HbA1c control (χ2 = 5.03 , p =.021).   Linear regression analysis shows medication control (F = 7.21, p <.010) and subjective sleep quality (PSQI) (F = 6.82, p <.010) affected glycemic control after controlling for age and duration of diabetes. HbA1c reduced 1.3% for every 1 point increase in medication compliance. HbA1c increased 0.1% for every 1 point increase in the PSQI score.
    Subjective sleep quality influence glycemic control in patients with diabetes. The findings of this study indicate subjective sleep quality assessment is important in helping better glycemic control in patients with diabetes.

Reference ( 150 ) 〈TOP〉

林宏達(1998)•糖尿病的歷史•中華民國內分泌暨糖尿病學會會訊，10，24-29。
連結：
林嘉玲、蘇東平、張媚（2003）–機構老人之睡眠品質及其相關因素•臺灣醫學，
連結：
林憶珊、楊南屏、周碧瑟(2009)•第二型糖尿病患口服藥物服藥順應性相關因子
連結：
周碧瑟(2002)•台灣地區糖尿病流行病學•台灣衛誌，21，83-96。
連結：
邱宗鴻(2009)•中華民國糖尿病衛教學會會訊，5-8。
連結：

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