Cox D J, Gonder-Frederick L, Julian D, Cryer P, Lee J H, Richards F E, Clarke W
University of Virginia Health Sciences Center, Charlottesville 22901.
Psychosom Med. 1991 Jul-Aug;53(4):453-62. doi: 10.1097/00006842-199107000-00010.
Insulin-dependent diabetes mellitus (IDDM) patients make critical daily self-care decisions on the basis of what they estimate their blood glucose (BG) levels to be. This study: a) replicated efficacy of Standard Blood Glucose Awareness Training (BGAT), b) evaluated the relative efficacy of an Intensive Blood Glucose Awareness Training (BGAT) to enhance patient accuracy of BG estimation, and c) evaluated the mechanisms and ancillary effects of BGAT. Thirty-nine subjects were randomly assigned to one of three groups. Compared with Control, both Standard and Intensive BGAT improved accuracy (p less than 0.001). Intensive BGAT post-treatment accuracy relative to Standard BGAT did not reach statistical significance (p = 0.177). Greater improvement in accuracy was associated with poorer pretreatment accuracy. Only Intensive BGAT improved metabolic control (glycosylated hemoglobin), and this improvement was associated with poorer pretreatment control. The effects of BGAT were highly specific, affecting only accuracy and metabolic control, and not affecting fear of hypoglycemia, diabetes knowledge, of frequency of blood glucose monitoring.
胰岛素依赖型糖尿病（IDDM）患者每天都要根据自己对血糖（BG）水平的估计做出关键的自我护理决策。本研究：a）重复了标准血糖认知训练（BGAT）的疗效，b）评估了强化血糖认知训练（BGAT）提高患者血糖估计准确性的相对疗效，c）评估了BGAT的机制和辅助效果。39名受试者被随机分配到三组中的一组。与对照组相比，标准BGAT和强化BGAT均提高了准确性（p<0.001）。强化BGAT治疗后的准确性相对于标准BGAT未达到统计学显著性（p = 0.177）。准确性的更大改善与治疗前较差的准确性相关。只有强化BGAT改善了代谢控制（糖化血红蛋白），且这种改善与治疗前较差的控制相关。BGAT的效果具有高度特异性，仅影响准确性和代谢控制，而不影响对低血糖的恐惧、糖尿病知识或血糖监测频率。
