應用遠距照護模式提升第二型糖尿病個案之血糖控制成效

Using Telecare to Facilitate Blood Sugar Control in Patients with Type 2 Diabetes

目的：本研究旨在分析遠距照護導入對居家第二型糖尿病個案血糖控制之成效。 材料與方法：本研究針對中部某醫學中心附設遠距照護中心所收案之第二型糖尿病個案，進行血糖異常原因及照護需求分析。根據要因分析結果，建立跨專業團隊、制定共同照護流程、建立遠距照護雲系統，培訓護理人員執行糖尿病遠距照護方案的能力。2017年7月起，對新加入此模式之38位糖尿病個案，進行三個月的照護，並評價照護前後糖化血色素變化以及血糖異常狀況。 結果：接受三個月遠距照護後，34位(89.4%)個案其糖化血色素有下降，整體糖化血色素平均下降2.4 ± 2.3(%)(p< .001)；高低血糖事件發生率下降分別為44.2%與37.5%。 結論：遠距照護可改善糖尿病個案血糖控制，並降低高低血糖異常事件之發生，此結果可提供臺灣未來推廣遠距照護之參考。

 

Objectives: This study analyzed the effect of telecare on the control of blood sugar in patients with type 2 diabetes. Materials and Methods: This study examined patients with type 2 diabetes at a telecare center of a medical center in central Taiwan and identified the causes of their blood sugar abnormalities and care needs. On the basis of the cause analysis, a professional interdisciplinary team was formed to implement care procedures and a telecare cloud system and cultivate the nurses’ ability to use telecare programs to treat people with diabetes. Starting in July 2017, we examined the preprogram and postprogram glycated hemoglobin levels and the occurrence of blood sugar abnormalities in the 38 patients with diabetes who joined the telecare program. Results: After the patients had participated in the telecare program for 3 months, 34 (89.4%) exhibited a decrease in their glycated hemoglobin levels; the average decrease was 2.4 ± 2.3% (p < .001). In addition, the occurrence of hyperglycemia and hypoglycemia decreased by 44.2% and 37.5%, respectively. Conclusion: This telecare program facilitated the control of blood sugar and decreased the occurrence of blood sugar abnormalities in patients with type 2 diabetes. The results of this study can serve as reference for the promotion of telecare in Taiwan.