已有 1 型或 2 型糖尿病的妇女在怀孕期间血糖控制的趋势和自我管理预测因素:一项队列研究。

Pub Date : 2023-05-01 Epub Date: 2022-12-23 DOI:10.2337/ds22-0046
Katelyn Sushko, Holly Tschirhart Menezes, Michelle Butt, Kara Nerenberg, Patricia Strachan, Muhammad Ali Usman, Diana Sherifali
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引用次数: 0

摘要

背景:由于孕期糖尿病管理的大部分工作是在家中进行的,因此自我管理因素(如自我效能、自我护理活动和护理满意度)可能会影响血糖。我们的目的是探索 1 型或 2 型糖尿病女性患者孕期血糖控制的趋势;评估自我效能、自我护理和护理满意度;并研究这些因素对血糖控制的预测作用:我们于 2014 年 4 月至 2019 年 11 月在加拿大安大略省的一家三级中心开展了一项队列研究。在孕期对自我效能、自我护理、护理满意度和 A1C 进行了三次测量(T1、T2 和 T3)。线性混合效应模型探讨了 A1C 的变化趋势,并研究了作为 A1C 预测因素的自我效能、自我护理和护理满意度:我们招募了 111 名女性(55 名 1 型糖尿病患者和 56 名 2 型糖尿病患者)。平均 A1C 从 T1 到 T2 显著下降了 1.09% (95% CI -1.38 到 -0.79),从 T1 到 T3 显著下降了 1.14% (95% CI -1.43 到 -0.86)。自我效能感对女性 2 型糖尿病患者的血糖控制有明显的预测作用,并且与量表每增加一个单位,A1C 平均变化-0.22% (95% CI -0.42 to -0.02)相关。自我保健的运动分值可显著预测1型糖尿病女性患者的血糖控制情况,每增加一个量表单位,A1C的平均变化幅度为-0.11%(95% CI -0.22至-0.01):结论:在加拿大安大略省的一组已患糖尿病的妇女中,自我效能感对孕期 A1C 有明显的预测作用。未来的研究将继续探索妊娠期糖尿病妇女的自我管理需求和挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Trends and Self-Management Predictors of Glycemic Control During Pregnancy in Women With Preexisting Type 1 or Type 2 Diabetes: A Cohort Study.

Background: Because much of diabetes management during pregnancy occurs at home, self-management factors such as self-efficacy, self-care activities, and care satisfaction may affect glycemia. Our objective was to explore trends in glycemic control during pregnancy in women with type 1 or type 2 diabetes; assess self-efficacy, self-care, and care satisfaction; and examine these factors as predictors of glycemic control.

Methods: We conducted a cohort study from April 2014 to November 2019 at a tertiary center in Ontario, Canada. Self-efficacy, self-care, care satisfaction, and A1C were measured three times during pregnancy (T1, T2, and T3). Linear mixed-effects modeling explored trends in A1C and examined self-efficacy, self-care, and care satisfaction as predictors of A1C.

Results: We recruited 111 women (55 with type 1 diabetes and 56 with type 2 diabetes). Mean A1C significantly decreased by 1.09% (95% CI -1.38 to -0.79) from T1 to T2 and by 1.14% (95% CI -1.43 to -0.86) from T1 to T3. Self-efficacy significantly predicted glycemic control for women with type 2 diabetes and was associated with a mean change in A1C of -0.22% (95% CI -0.42 to -0.02) per unit increase in scale. The exercise subscore of self-care significantly predicted glycemic control for women with type 1 diabetes and was associated with a mean change in A1C of -0.11% (95% CI -0.22 to -0.01) per unit increase in scale.

Conclusion: Self-efficacy significantly predicted A1C during pregnancy in a cohort of women with preexisting diabetes in Ontario, Canada. Future research will continue to explore the self-management needs and challenges in women with preexisting diabetes in pregnancy.

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