The risk of diabetes mellitus can increase with age, and the prevalence of prediabetes and diabetes mellitus in the middle-aged and elderly adults is 40% and 10%, respectively. Good adherence to blood glucose monitoring improves the rate of glycohemoglobin compliance. However, adherence to blood glucose monitoring is poor in patients with type 2 diabetes mellitus (T2DM) in rural areas.

To investigate and understand the blood glucose monitoring situation of middle-aged and elderly patients with T2DM aged 45 to 65 years in rural areas of Zhongmou County, Henan Province, explore the psychological and behavioral factors affecting their adherence to blood glucose monitoring and monitoring frequency, so as to provide a reference for targeted interventions to improve the blood glucose monitoring compliance of the middle-aged and elderly patients with T2DM in rural areas.

Middle-aged and elderly T2DM patients in rural areas of Zhongmou County, Henan Province from November 2 to 12, 2021 were selected to conduct for questionnaire survey by using convenience sampling method. A self-designed general information questionnaire was used to investigate their basic information and blood glucose monitoring. Additionally, the Five-item Mindful Awareness Attention Scale (MAAS-5), Generalized Anxiety Disorder Questionnaire (GAD-7), Patient Health Questionnaire (PHQ-9), and Diabetic Self-management Scale (DSMS) were used to investigate their mindfulness, anxiety, depression, and self-management ability, respectively. Univariate analysis, multivariate Logistic regression and negative binomial regressions were used to explore the influencing factors of situation and frequency of blood glucose monitoring and monitoring frequency in middle-aged and elderly T2DM patients.

A total of 484 questionnaires were collected, and 469 were enrolled in this study, with a recovery rate of 96.9%. Of the 469 patients, 58.8% (276/469) were unable to monitor blood glucose monthly, and the frequency of monthly blood glucose measurements for the 193 patients who monitored blood glucose ranged from 1 to 60 times, with a median of 2 times. Logistic and negative binomial regression analysis showed that depression symptoms (AOR=1.127, P=0.005), high information level (AOR=0.133, P=0.023), and high motivation level (AOR=1.093, P=0.002) were facilitators of blood glucose monitoring; high annual income (AIRR=2.063, P<0.001) and alcohol consumption in the past 1 year (AIRR=1.569, P=0.011) were facilitators of blood glucose monitoring frequency. Smoking in the past 6 months (AOR=0.559, P=0.043) was a barrier of blood glucose monitoring; aged over 60 years (AIRR=0.668, P=0.024) was a barrier of blood glucose monitoring frequency.

The blood glucose monitoring status of middle-aged and elderly T2DM patients in rural areas is relatively poor, therefore, it is recommended that relevant health authorities should strengthen health education such as blood glucose monitoring knowledge and skills, provide medical and financial social support for low-income populations, to improve blood glucose monitoring compliance and achieve effective control, treatment, and rehabilitation of T2DM.

糖尿病的发病风险随着年龄的增加而升高，在中老年人群中，糖尿病前期和糖尿病的患病率分别为40%和10%，良好的血糖监测依从性可提高糖化血红蛋白达标率，但农村地区2型糖尿病（T2DM）患者血糖监测依从性较差。

调查河南省中牟县农村地区中老年T2DM患者血糖监测情况，探索影响其血糖监测依从性及监测次数的心理、行为因素，为后续开展针对性干预试验以提高农村中老年T2DM患者的血糖监测依从性提供参考。

采用便利抽样的方法，于2021-11-02—12选取河南省中牟县农村地区的中老年T2DM患者作为研究对象进行问卷调查。采用自行设计的一般资料问卷调查患者的基本资料、血糖监测情况等，使用五条目正念注意觉知量表（MAAS-5）、广泛性焦虑障碍量表（GAD-7）、病人健康问卷（PHQ-9）和糖尿病自我管理量表（DSMS）调查患者的正念水平、焦虑水平、抑郁水平和自我管理能力。采用单因素分析、多因素Logistic回归分析及负二项回归分析探索中老年T2DM患者血糖监测及监测次数的影响因素。

本研究共回收问卷484份，录入问卷469份，有效回收率为96.9%。469例患者中，不能每月监测血糖者占58.8%（276/469），193例监测血糖者每月测量血糖的频次范围为1~60次，中位数为2次。多因素Logistic回归及负二项回归分析发现：存在抑郁（AOR=1.127，P=0.005）、高信息水平（AOR=0.133，P=0.023）、高动机水平（AOR=1.093，P=0.002）为血糖监测的促进因素，高年收入（AIRR=2.063，P<0.001）、过去1年内饮酒（AIRR=1.569，P=0.011）为血糖监测次数的促进因素；而近6个月吸烟（AOR=0.559，P=0.043）为血糖监测的阻碍因素；年龄>60岁（AIRR=0.668，P=0.024）为血糖监测次数的阻碍因素。

农村地区中老年T2DM患者血糖监测状况较差，建议有关卫生部门加强血糖监测知识及技能等健康教育，对低收入人群提供医疗、财政等社会支持，提高血糖监测依从性，以实现对T2DM的有效控制、治疗和康复。