Analysis of blood glucose control and level of self-management in diabetic patients in the Nanjing community

Abstract

Objective To explore the blood glucose control status, influencing factors, and self-management level of patients before participating in diabetes self-management groups in the Nanjing community, and to provide baseline data and the scientific basis for the community to promote self-management activities for diabetic patients. Methods From April to June 2017, patients in diabetes self-management groups were recruited through the use of multi-stage cluster random sampling. Prior to the self-management group activities, patients were surveyed for general conditions, physical examinations and blood glucose and blood lipid tests were conducted, and the Chronic Disease Self-Management Research Measurement Form was used to investigate the patient's self-management level face to face. Results A total of 345 diabetic patients were included, and 342 effective scales were returned with an effective rate of 99.1%. The age of the 342 patients with diabetes was (63.8±8.7) years, 129 (37.7%) were male and 213 (62.3%) were female. The average levels of FPG and HbA1c were (7.61±2.23) mmol / L and (7.15±1.57) %, respectively. The FPG and HbA1c control compliance rates were 44.7% (153 cases) and 52.3% (179 cases), respectively. The level of FPG [(7.85±2.32) mmol/L compared with (7.29±2.07) mmol/L] and HbA1c[(7.31±1.78) mmol/L compared with (6.93±1.23) mmol/L] was higher in patients with a diabetes course ≥5 years than that of patients with diabetes course <5 years, and the level of HbA1c [(7.30±1.64) mmol/L compared with (6.92±1.44) mmol/L] was higher in patients with primary school education and below than that in junior high school and above. Compared with the non-control group, the proportion of married patients (42.9%, 132 cases) in the FPG control group was lower, with lower levels of BMI [(23.38±3.27) kg/m2vs. (26.27±3.40) kg/m2], waist circumference [(84.47±10.97) cm vs. (88.74±10.48) cm], and hip circumference [(94.46±8.68) cm vs. (97.40±9.92) cm]. In the HbA1c control group, the proportion of males (44.2%, 57 cases), those with primary school education or below (47.3%, 97 cases), and those with a diabetes course ≥5 years (44.1%, 86 cases) were lower. BMI [(25.52±3.50) kg/m2vs. (26.26±3.19) kg/m2], waist circumference [(85.34±11.63) cm vs. (88.47±9.80) cm], systolic blood pressure [(132.65±14.73) mmHg vs. (136.15±15.14) mmHg], total cholesterol [(4.41±1.08) mmol/L vs. (4.76±1.11) mmol/L], and triacylglycerol [(1.67±0.72) mmol/L vs. (1.92±1.12) mmol/L] were all lower, and the levels of HDL [(2.73±0.97) mmol/L was higher than that of (2.48±1.02) mmol/L], with statistically significant differences (all P <0.05). In terms of the level of self-management, compared with the non-control group, the weekly stretching and/or strength training time of the FPG control group was (26.27±41.27) min higher than (17.06±33.46) min, and the difference was statistically significant (P<0.05); HbA1c control group weekly stretch and/or strength exercise time (7.32±20.82) min vs. (16.47±14.33) min, weekly endurance exercise time (105.67±50.75) min vs. (91.66±51.07) min, symptom management self-efficacy (6.87±1.62) points (6.36±1.93) points were higher, fatigue (2.52±2.23) points(3.07±2.54) points, dyspnea (0.27±0.82) points (0.67±1.46) points, social. Both the activity and/or role restriction scores (0.58±0.64) and (0.74±0.79) scores were lower, and the differences were statistically significant (all P<0.05). Conclusions Patients with diabetes in communities in Nanjing have better blood glucose control and higher levels of self-management. Patients with good control of BMI, blood pressure and blood lipids have higher blood glucose compliance rates. Communities with conditions can gradually promote self-management group activities to further control patients' blood glucose levels and reduce the incidence of complications. Key words: Diabetes; Blood glucose control; Influencing factors; Self-management