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1型糖尿病患儿持续葡萄糖监测的心理方面

Psychological aspects of continuous glucose monitoring in pediatric type 1 diabetes.

出版信息

Pediatr Diabetes. 2006 Feb;7(1):32-8. doi: 10.1111/j.1399-543X.2006.00142.x.

Abstract

Clinical use of near-continuous glucose monitors (CGMs) could have substantial impact on family management of pediatric type 1 diabetes and could generate both beneficial and adverse psychological reactions. In addition to glycemic benefits, CGM could possibly yield educational and motivational benefits. Conversely, CGM may also lead to information overload and increased treatment burden. Further, patients and families with certain affective, behavioral, and cognitive characteristics might derive greater benefit from CGM use. As information about these processes could facilitate optimal clinical use of CGM, the Diabetes Research in Children Network (DirecNet) included measurement of selected psychological variables in a recent randomized trial of the GlucoWatch G2 Biographer (GW2B, Cyngus, Inc., Redwood City, CA, USA). A multicenter sample of 200 youths with type 1 diabetes was randomized to 6 months of either continued usual care (UC) using a conventional home glucose meter for diabetes or supplementation of standard care with use of the GW2B. Diabetes treatment adherence, diabetes-specific quality of life, and diabetes-related anxiety were measured at baseline and at the end of the study. Satisfaction with use of the GW2B was measured at the end of the study. The results indicated neither adverse nor beneficial psychological effects of CGM use. More frequent GW2B use over the 6-month study was found among youths whose parents reported higher scores for treatment adherence and diabetes-related quality of life at baseline. The study illustrates the empiric assessment of the psychological context of CGM use and establishes methods that are applicable to new CGM devices as they emerge.

摘要

近连续血糖监测仪(CGM)的临床应用可能会对1型糖尿病患儿的家庭管理产生重大影响,并可能引发有益和不良的心理反应。除了血糖方面的益处外,CGM还可能带来教育和激励方面的好处。相反,CGM也可能导致信息过载和治疗负担增加。此外,具有某些情感、行为和认知特征的患者及其家庭可能会从使用CGM中获得更大的益处。由于有关这些过程的信息有助于CGM的最佳临床应用,儿童糖尿病研究网络(DirecNet)在最近一项关于GlucoWatch G2生物记录仪(GW2B,Cyngus公司,美国加利福尼亚州红木城)的随机试验中纳入了对选定心理变量的测量。200名1型糖尿病青少年的多中心样本被随机分为两组,一组继续使用传统家用血糖仪进行常规护理(UC)6个月,另一组在标准护理基础上使用GW2B进行补充护理。在基线和研究结束时测量糖尿病治疗依从性、糖尿病特异性生活质量和糖尿病相关焦虑。在研究结束时测量对GW2B使用的满意度。结果表明使用CGM既没有不良心理影响也没有有益心理影响。在基线时父母报告治疗依从性和糖尿病相关生活质量得分较高的青少年中,在为期6个月的研究中GW2B的使用频率更高。该研究说明了对CGM使用心理背景的实证评估,并建立了适用于新出现的CGM设备的方法。

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