| Objective:The purpose of this study was to assess effects of glucose fluctuation management on the glycemic control,lipid profile,nerve function(The National Institute of Health Stroke Scale,NIHSS),life ability(Modified Ranking Scale,MRS),quality of life(Stroke Impact Scale,SIS)and diabetes self-management skills(Summary of Diabetes Self Care Activities,SDSCA)in type 2 diabetes patients with cerebral infarction.Methods:This was a randomized controlled.trial.75 type 2 diabetes patients with cerebral infarction were randomly divided into 2 groups:control group(n=37),and intervention group(n=38).The two groups were given "one to one" diabetes education during hospitalization.After discharge,the patients were asked to monitor blood glucose 5 times a day during a week and follow-up at outpatient clinic once a month.During each follow-up,subjects in the control group were paid attention to the blood glucose control;Participants in the intervention were paid more attention to the glucose fluctuation on the basis of glucose control.If the blood glucose fluctuations caused by lifestyle or events,the researchers worked with patients to find the cause of glucose fluctuation,analysis and set behavioral change goals,next time,they will track the achievement of the goal;If the blood glucose fluctuations caused by drugs,researchers referred the patient to the doctor.Medications were adjusted by the doctors.After 6 months,weight,HbAlc,blood glucose,lipid profile 1,5-AG,LAGE and CV-FPG were tested,in addition to this,nerve function,life ability,quality of life and diabetes self-management skills were also evaluated.Results:75 patients were recruited in the study,after 6 months,the data of 63 patients were finally analyzed(30 in the control group,33 in the intervention group).Between 2 groups,the baseline was comparable(P>0.05).After the intervention,there was no different(P>0.05)in the difference value(6 months later-baseline)of HbAlc between 2 groups.The difference value of LDL,2hPG,LAGE and 1,5-AG were significant difference between two groups(P=0.046,P=0.041,P=0.030,P=0.023,respectively).Within intervention group,2hPG,HbAlc,1,5-AG and LAGE were significantly different before and after the 6 months' intervention(P=0.041,P=O.O11,P<0.001,P=0.015,respectively).Correspondingly,in control group,there was statistically significant in HC,HDL,LDL and 1,5-AG(P=0.008,P=0.001,P=0.035,P=0.037,respectively).On the nerve function,the NIHSS score in intervention group was 2.35±0.81 and that of control group was 3.50 ±2.24.The difference was statistically significant(P=0.047).On the quality of life,there was no significant difference in total score of SIS between the two groups.But in the intervention group,the scores in the strength,hand function,and participation dimensions were higher than those of the control group(P=O.041,P=0.049,P=0.048,respectively).After 6 months,no statistically significant difference was identified between two groups in scores of MRS and SDSCA.Conclusions:1.After 6 months,compared with control group,those attended glucose fluctuation management achieved better 2hPG,1,5-AG,LAGE and LDL.2.After 6 months,compared with control group,glucose fluctuation management reduced the nerve function defect and improved the quality of life of the patients.3.After 6 months,control group and glucose fluctuation management group had similar effects in increasing life ability and diabetes self-management skills... |
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