目的：本研究目的在探討經由糖尿病志工電話提醒之介入，對糖尿病患者遵從醫囑行為的改變，及血糖控制的影響。方法：本研究採隨機試驗設計，以某醫學中心新陳代謝科門診之第二型糖尿病患者為研究對象，將研究對象隨機分派至實驗組及對照組各組50人。實驗組接受門診個別衛教及糖尿病志工電話追蹤個案遵循醫囑之狀況，對照組則僅接受門診個別衛教。研究對象於收案時及每次回診時自行填寫「糖尿病患者遵醫囑執行率問卷」，並接受空腹血糖值及糖化血色素值的測試，每位個案皆進行三個月追蹤。完成收案者共有85人，其中實驗組47人，對照組38人。結果：在遵醫囑行為方面，實驗組在服藥規律性、運動頻率執行率優於對照組，在有關不當飲食習慣部分包括常外食頻率、喜歡吃油炸類食物及喜歡吃零食方面的執行率方面，實驗組也有明顯改善，經獨立樣本t檢定達顯著差異(P<0.05)；在生理檢查方面，實驗組的空腹血糖值的改善情形明顯優於對照組，經獨立樣本t檢定達顯著差異(P<0.05)。結論：經由糖尿病志工電話提醒之介入措施，可提升糖尿病患者的遵醫囑行為，並控制血糖。
Objective: To assess the effects of telephone reminders on glycemic control among diabetic patients. Methods: In this randomized clinical trial, we recruited 100 patients who visited the diabetic clinic of a medical center in central Taiwan between January 2003 and May 2003. After an initial consultation, patients were randomly assigned to a study or a control group. Members of the study group were telephoned by volunteers once per week to remind them to follow the instructions they received from physicians and nursing specialists. Members of the control group only received the initial consultation. During the study, the fasting blood sugar and HbA1c of the patients were measured, and data on their exercise, medication, dietary regimens, and follow-up rates were collected by questionnaire. Results: For members of the study group, the mean of fasting blood glucose decreased from 227 mg/dl to 159 mg/dl (30%), a significantly higher decrease than that found in the control group (p<.05). Furthermore, adherence to exercise, medication, and dietary regimes was also higher in the study group than in the control group. Conclusion: The telephone reminder program was effective in improving the glycemic level of diabetic patients as well as their adherence to exercise, medication, and dietary regimes.
