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。

Q3 Medicine

Diabetes Spectrum 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。

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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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来源期刊

Diabetes Spectrum Medicine-Internal Medicine

CiteScore

2.70

自引率

0.00%

发文量

期刊介绍： The mission of Diabetes Spectrum: From Research to Practice is to assist health care professionals in the development of strategies to individualize treatment and diabetes self-management education for improved quality of life and diabetes control. These goals are achieved by presenting review as well as original, peer-reviewed articles on topics in clinical diabetes management, professional and patient education, nutrition, behavioral science and counseling, educational program development, and advocacy. In each issue, the FROM RESEARCH TO PRACTICE section explores, in depth, a diabetes care topic and provides practical application of current research findings.