Ritholz M D, Beste M, Edwards S S, Beverly E A, Atakov-Castillo A, Wolpert H A
Behavioral Mental Health, Joslin Diabetes Center; Department of Psychiatry, Harvard Medical School; Department of Psychiatry, Boston Children's Hospital.
Diabet Med. 2014 Jan;31(1):47-54. doi: 10.1111/dme.12276. Epub 2013 Jul 24.
To examine the impact of continuous glucose monitoring on diabetes management and marital relationships of adults with Type 1 diabetes and their spouses.
Nine younger (30-49 years) and 11 older (50-70 years) patients with Type 1 diabetes and 14 spouses participated in eight focus groups specific to age and role (patient or spouse). Audio-recorded data were transcribed, coded and analysed using thematic analysis and aided by NVivo software.
Qualitative analysis revealed participants perceived continuous glucose monitoring as positively influencing hypoglycaemia management by decreasing spouses' anxiety, vigilance and negative experiences. Participants also described continuous glucose monitoring as promoting collaborative diabetes management and increasing spousal understanding of diabetes, especially when planning and managing pregnancy. Couples' conflicts occurred when (1) patients assumed sole responsibility for continuous glucose monitoring and/or did not respond to night-time glucose alarms and (2) spouses did not understand alarms and felt frustrated and helpless to assist patients.
Our findings suggest that continuous glucose monitoring may positively impact collaborative diabetes management and marital relationships of patients with Type 1 diabetes and their spouses. However, reluctance to collaborate and lack of understanding may contribute to couples' conflicts around continuous glucose monitoring. Our findings have important implications for clinical care and point to the need for interventions that include spouses in continuous glucose monitoring training to increase their understanding of continuous glucose monitoring, minimize risk for spousal conflict and enhance collaborative diabetes management. Further studies are needed to explore these issues in more detail and depth with larger and more diverse populations.
探讨持续血糖监测对1型糖尿病成年患者及其配偶的糖尿病管理和婚姻关系的影响。
9名年龄较轻（30 - 49岁）和11名年龄较大（50 - 70岁）的1型糖尿病患者以及14名配偶参加了8个针对年龄和角色（患者或配偶）的焦点小组。对录音数据进行转录、编码，并使用主题分析进行分析，同时借助NVivo软件辅助分析。
定性分析显示，参与者认为持续血糖监测通过减轻配偶的焦虑、警惕性和负面体验，对低血糖管理产生积极影响。参与者还描述持续血糖监测促进了糖尿病的协同管理，并增进了配偶对糖尿病的理解，尤其是在计划和管理妊娠期间。当出现以下情况时，夫妻间会发生冲突：（1）患者承担持续血糖监测的全部责任，和/或对夜间血糖警报没有反应；（2）配偶不理解警报，感到沮丧且无法帮助患者。
我们的研究结果表明，持续血糖监测可能对1型糖尿病患者及其配偶的糖尿病协同管理和婚姻关系产生积极影响。然而，不愿合作和缺乏理解可能会导致夫妻在持续血糖监测方面产生冲突。我们的研究结果对临床护理具有重要意义，并指出需要开展干预措施，让配偶参与持续血糖监测培训，以增进他们对持续血糖监测的理解，将配偶冲突风险降至最低，并加强糖尿病的协同管理。需要进一步研究，以更详细和深入地探讨这些问题，研究对象包括更大规模和更多样化的人群。
