关键词: 糖尿病, 2型；老年人；自制糖尿病饮食管理器；自我管理；血糖自我监测

Abstract: Background　Poor treatment adherence and glycemic control are common in older adults with diabetes. Diet is strongly associated with glycemic control，so studying diet management will greatly contribute to prognosis improvement of diabetic patients. Objective　To examine the effect of a self-made diabetic diet manager in empty nesters with type 2 diabetes and poor glycemic control. Methods　Participants were 120 empty nesters with type 2 diabetes and poor glycemic control selected from the Third Affiliated Hospital of Gansu University of Chinese Medicine，including 60 hospitalized between February and October 2018（traditional group with 6-month-follow-up routine health education），and 60 hospitalized between February and October 2019（diabetic diet manager group with 6-month-follow-up intervention using a diabetic diet manager developed by our research group）. Medical records and complete follow-up data were collected retrospectively. Pre- and post-follow-up fasting and two-hour postprandial glucose levels and self-care ability（evaluated by the Summary of Diabetes Self-care Activities）of two groups were compared. The complications and readmission of the two groups during intervention were observed and recorded. Results　After 6 months of intervention，the fasting blood glucose，two-hour postprandial blood glucose and glycated hemoglobin levels fell notably in both groups（P<0.05），and they decreased more significantly in diabetic diet manager group（P<0.05）. Both groups had an obvious increase in the scores of successful self-management of diet and exercise，blood glucose self-monitoring and taking medicines as prescribed（P<0.05），and a more significantly increase was observed in diabetic diet manager group（P<0.05）. No peripheral neuropathy and macroangiopathy were found in both groups. The incidence of diabetic retinopathy and diabetic nephropathy，and readmission rate in diabetic diet manager group were lower than those in the traditional group（P<0.05）. Conclusion　The intervention using the diabetes diet manager developed by us may be far superior to traditional health education in terms of improving self-care ability and glycemic control，as well as reducing complication incidence and readmission rate in empty nesters with type 2 diabetes and poor glycemic control，indicating that it has a high value of clinical application.

Key words: Diabetes mellitus, type 2；Aged；Self-made diabetes diet manager；Self-management；Blood glucose self-monitoring