Application Of SDM-based Individualized Management Model In Type 2 Diabetes Patients Receiving Insulin Therapy

Objective:In this study,T2 DM patients receiving insulin treatment were treated with routine management guidance and SDM-based individualized management guidance.Evaluating the application effects by observing the patient's glycemic control and changes in BMI,blood pressure,blood lipids,evaluating the self-management behavior and the satisfaction of medical decision-making participation.Providing a new scheme for the implementation of individualized management of T2 DM patients.Methods:78 patients with T2 DM who were treated with insulin were enrolled in the study.They were randomly divided into SDM group(n =38)and non-SDM group(n = 40).The SDM group used decision-making aids,and the doctors and patients jointly developed individualized management programs.The non-SDM group received routine management guidance.The patients were followed up at 1,2,3,4,6,8,12 weeks.At the12 th week,blood glucose control and the changes of BMI,blood pressure,blood lipids,self-management behavior and satisfaction of the decision-making participation were compared between the two groups to evaluate the application effects.Results:(1)Blood glucose control: Compared with pre-intervention,both groups were able to control FPG,2h PG and Hb A1 c level,and the effect of SDM group were superior to those of non-SDM group(P<0.05).During the intervention period,the incidence of hypoglycemia in SDM group was lower than non-SDM group,but there was no significant difference(P>0.05).(2)Changes of BMI,blood pressure and blood lipids: Compared with pre-intervention,TC,TG,LDL-C in non-SDM group decreased significantly(P<0.05),but there was no significant difference in BMI,SBP,DBP,HDL-C(P>0.05).BMI,DBP,TC,TG and LDL-C in SDM group decreased significantly(P<0.05),but there was no significant difference in SBP and HDL-C(P>0.05).Compared with non-SDM group,the BMI,TG,and LDL-C of SDM group decreased significantly(P<0.05).(3)The scores of SDSCA-6 scale: Compared with pre-intervention,the scores of healthy diet,exercise and blood glucose monitoring in the two groups were higher(P<0.05).In terms of treatment compliance,the scores of patients in SDM group were significantly higher than those before(P<0.05),but there was no significant change in non-SDM group(P>0.05).Compared with the non-SDM group,the scores of healthy diet,exercise and blood glucose monitoring after intervention in the SDM group were higher(P<0.05).(4)Patients' satisfaction with medical decision participation: The satisfaction degree of the decision-making participation in the SDM group was significantly higher than non-SDM group(P<0.05).Conclusion:In this study,the SDM-based individualized management model can effectively improve the control effects of glycemic,BMI,blood pressure and blood lipids,and improve self-management behavior and satisfaction of medical decision-making participation in T2 DM patients receiving insulin therapy.It is superior to the traditional management model and can be popularized in clinic.