目的了解2型糖尿病患者糖尿病控制及糖尿病教育、自我管理现状并分析同伴支持对糖尿病患者自我管理及血糖控制水平的效果方法于2012年10月-2013年2月在世界健康基金会“中国糖尿病教育项目”所属9个二级培训中心门诊采取简单抽样的方法选取1887例2型糖尿病患者进行横断面调查。采用自编问卷、糖尿病患者知识量表（ADKnowl）和糖尿病自护行为量表(SDSCA）收集患者人口学、血糖相关指标、糖尿病知识水平及自我管理行为等信息。采用回归模型分析同伴支持对2型糖尿病患者自我管理行为、血糖控制的效果。结果1887例2型糖尿病患者接受本次调查（其中913名男性，平均年龄为59.91±11.63岁）。表示接受过糖尿病教育和加入同伴支持小组的患者比例分别为84.8%，31.9%。糖尿病知识问卷正确率为69.79%±13.74%。加入同伴支持小组的患者糖尿病知识水平较高。SDSCA量表(0-7)各维度得分依次为服药依从性 (6.43±1.50) , 一般饮食(5.15±2.03), 运动 (3.85±2.70), 足部护理(3.55±2.80), 特殊饮食(3.25±1.53), 血糖监测(2.06±2.02)。回归分析显示加入同伴支持（与特殊饮食、运动、血糖监测、足部护理和用药依从性有关）、糖尿病知识水平高（与一般饮食、足部护理和服药依从性有关）、文化程度（与普通饮食、特殊饮食、运动和用药依从性）为患者自我照顾行为的三大影响因素。所有患者平均糖化血红蛋白值（HbA1c）为8.07±2.20%，仅36.65%的患者HbA1c达标(＜7.0%)。回归分析显示在校正年龄、就诊医院、文化程度、糖尿病病程、自我管理行为后，同伴支持可提高HbA1c 达标可能性。结论中国糖尿病患者血糖控制及自我管理现状不理想；同伴支持小组有助于提高患者糖尿病知识水平，帮助患者进行糖尿病自我管理及血糖控制。

Aimto investigate the efficacy of peer support on glycemic control and self-management behaviors among patients with type 2 diabetes mellitus (DM) receiving diabetes management from 9 Project HOPE’s China diabetes program sites (2 primary hospitals, 3 secondary hospitals and 4 tertiary hospitals) in China.MethodsA cross-sectional survey through face-to-face questionnaire interview was carried out in outpatients with type 2 DM from October 2012 to February 2013 in the 9 hospitals located in 7 provinces of China to obtain the demographic, medical characteristics, diabetes knowledge and self-management characteristics by using a self-edited scale, The Audit of Diabetes Knowledge (ADKnowl) scale and the Summary of Diabetes Self-Care Activities (SDSCA) scale, respectively. Regression models were used to analyze the effect of peer support on self-management behaviors and glycemic control among patient with type 2 diabetes in china.ResultsAmong 1887 eligible respondents [913 males; mean age(59.91±11.63)], 84.8% considered themselves educated on diabetes and 31.9% claimed to have joined peer support groups. The mean (± standard deviation, SD) HbA1c level was 8.07(2.20). The mean percentage of correct answers to ADKnowl was 69.79±13.74, patients who joined peer support groups also scored higher on diabetes knowledge.The mean scores for subscales of SDSCA were ranked as medication (6.43±1.50) , general diet (5.15±2.03), exercise (3.85±2.70), foot care (3.55±2.80), special diet (3.25±1.53), blood glucose testing (2.06±2.02) on a scale of 0-7. Logistic regression analysis revealed joining peer support groups (associated with special diet, exercise, blood glucose testing, foot care and medication), higher diabetes knowledge level (associated with general diet, foot care and medication) and literacy level (associated with general diet, special diet, exercise and medication) were top three relevant factors associating with better self-care activities. 36.65% of subjects met the target of tightly glycemic control when a threshold of HbA1c＜7.0% was used. The odds ratio (OR) of unsatisfactory glycemic control (HbA1c≥7.0%) were higher (P＜0.05) in patients with the following characteristics: younger age, from higher level hospitals, lower literacy level, longer duration of diabetes, having not joined peer support group, worse adherence to dietary intervention.ConclusionGlycemic control and self-management behaviors are not ideal among patients with type 2 diabetes in China. Peer support has played an important role in not only diabetes self-care behaviors and knowledge, but also glycemic control among them, which should be promoted in a wider scope. Primary hospitals have showed great potential in helping improvement of diabetes patients’ education and self-management. More efforts are required to help capacity building at primary-hospital level.