Stenström U, Andersson P
University College of Health Sciences, Box 1038, S-551 11, Jönköping, Sweden.
Diabetes Res Clin Pract. 2000 Oct;50(2):103-7. doi: 10.1016/s0168-8227(00)00169-8.
The relations between blood glucose control (HbA(1c)), smoking, and health-related diabetes locus of control beliefs were studied in a consecutive adult sample of 187 patients with Type 1 diabetes who were free of diabetes complications. Those who were smokers (n=32) had poorer HbA(1c) values than non-smokers [7.5+/-1.4 (S.D.) vs 6. 8+/-1.2%, P=0.017]. When the patients were compared according to HbA(1c) quartiles, 17 of the smokers (53%) were found among those with worst blood glucose control. The smokers showed a lesser belief than the non-smokers in powerful others such as physicians and diabetes nurses in regards as diabetes control and the course of the disease [23.5+/-4.4 (S.D.) vs 25.8+/-5.5 (S.D.), P=0.05]. The group as a whole exhibited strong beliefs that their own behaviour was important for diabetes control. This belief appears incongruent with smoking behaviour. The results have implications for possible coping and defence strategies used by the smokers. Due to their worse blood glucose control, weaker beliefs in health care professionals, and possible denial-like coping strategies, smokers clearly need special attention in diabetes care, particularly in the view of their risk of developing long-term complications.
在187例无糖尿病并发症的1型糖尿病成年患者连续样本中，研究了血糖控制（糖化血红蛋白）、吸烟与健康相关的糖尿病控制信念之间的关系。吸烟者（n = 32）的糖化血红蛋白值比不吸烟者差[7.5±1.4（标准差）对6.8±1.2%，P = 0.017]。根据糖化血红蛋白四分位数对患者进行比较时，发现17名吸烟者（53%）处于血糖控制最差的人群中。在糖尿病控制和疾病进程方面，吸烟者比不吸烟者更不相信医生和糖尿病护士等权威他人[23.5±4.4（标准差）对25.8±5.5（标准差），P = 0.05]。总体而言，该组患者坚信自己的行为对糖尿病控制很重要。这种信念似乎与吸烟行为不一致。研究结果对吸烟者可能采用的应对和防御策略具有启示意义。由于吸烟者血糖控制较差、对医护人员的信任较弱以及可能采用类似否认的应对策略，显然在糖尿病护理中需要特别关注吸烟者，尤其是考虑到他们发生长期并发症的风险。
