高妍教授——糖尿病管理个体化挑战与对策.pptVIP

所以，糖尿病治疗面临的挑战不断变化，包括糖尿病患者持续增加、住院患者高血糖常见、糖尿病的治疗不仅局限在内分泌科、糖尿病人群不断变化：儿童、妊娠、老年等特殊年龄糖尿病患者日益增多 如何应对糖尿病管理的多样性挑战呢？这就需要对不同的患者做到个体化的管理。只有了解不同患者的不同需求，才能做到治疗的个体化。 /endocr/info-progress/show-40950_46.html * OBJECTIVE：Short-term intensive insulin treatment in patients with newly diagnosed type 2 diabetes can improve b-cell function and insulin sensitivity,which results in long-term remission without need for further antidiabetes medication. Patient attitudes toward their disease were assessed using the Diabetes Care Profile (DCP) tool to evaluate the potential impact on maintaining long-term remission. RESEARCH DESIGN AND METHODS：Newly diagnosed patients with type 2 diabetes were recruited and treated with continuous subcutaneous insulin infusion (CSII) for 2–3 weeks. They were also invited to participate in diabetes self-management intervention during hospitalization and complete a DCP questionnaire on attitudes toward diabetes at baseline and 3, 6, and 12 months after suspension of CSII. RESULTS：Near normoglycemia was achieved by 118 patients after short-term CSII, with 65 remaining in drug-free remission for.1 year. They had significantly better glycemic control and greater restoration of acute insulin response after CSII as well as higher educational attainment compared with patients experiencing relapse. They also achieved higher scores in positive attitude, (belief in) importance of care, care ability, self-care adherence, and less negative attitude. Differences between the two groups became greater over time. Cox proportional hazards model analysis indicated that greater self-care adherence (hazard ratio 0.184, P , 0.001) and homeostasis model assessment of insulin resistance before treatment (0.854, P = 0.053) were independent predictors for long-term remission, whereas elevated 2-h postprandial plasma glucose after CSII (1.156, P = 0.015) was a risk factor for relapse. CONCLUSIONS：Attitudes toward diabetes affect long-term drug-free remission in newly diagnosed patients