インスリン自己注射を行っている血糖コントロール不良糖尿病患者における自己管理上の要因

poor glycemic control

看護総合科学研究会誌

The purposes of this study were to clarify the factors which influence on poor glycemic control in diabetic patients with a self-management insulin therapy and to consider the methods of better patient education for good glycemic control. A questionnaire survey was carried out to eighty-four diabetics (type 1 and 2) at the outpatient clinic in the A hospital. The patients were divided into poor and stable control groups according to the guideline for diabetes practice (Japan Diabetes Society). Glycemic control status, dosage and times of insulin therapy, and living environment factors of the patients were evaluated. In the poor control group, most of the patients did not realize their actual inadequate glycemic control status and the importance of an individual targeted value for adequate glycemic control. Less intensive insulin therapy in the poor control group was noted. As living environment factors, difficulties in regular dietary intake and regular insulin injection due to irregular working hours, and in adequate dietary management due to dining out were evident. To achieve good glycemic control in diabetic patients with a self-management insulin therapy, positive nursing intervention to the patients was considered to be important by guiding a proper individual targeted value and by educating proper methods to achieve good glycemic control.