Cox D J, Carter W R, Gonder-Frederick L A, Clarke W L, Pohl S L
University of Virginia Medical School, Charlottesville.
Biofeedback Self Regul. 1988 Sep;13(3):201-17. doi: 10.1007/BF00999170.
Self-management of insulin-dependent diabetes mellitus (IDDM) is dependent on a negative feedback loop of blood glucose (BG) fluctuations, which in turn directs treatment decisions to maintain normal BG. Although this feedback is typically accomplished by self-monitoring of blood glucose (SMBG), SMBG has limitations, and patients often rely on what their BG "feels" like. Two studies were performed to evaluate whether patients could learn to more accurately "feel"/discriminate their BG on the basis of internal cues or internal plus external BG cues. In Study I, BG Awareness Training significantly improved pre- to posttreatment BG estimation accuracy, relative to a control group. Study II replicated BG Awareness Training efficacy in improving BG estimation accuracy. Improvement in estimation accuracy was related only to initial accuracy; those who were initially less accurate improved the most. This improvement was represented in a 31% reduction in dangerous BG estimation errors and a 9% increase in accurate estimates. Resulting estimations were, however, still significantly less accurate than SMBG at the end of training.
胰岛素依赖型糖尿病（IDDM）的自我管理依赖于血糖（BG）波动的负反馈回路，该回路反过来指导治疗决策以维持正常血糖水平。虽然这种反馈通常通过自我血糖监测（SMBG）来实现，但SMBG存在局限性，患者往往依赖于自己对血糖“感觉”如何。进行了两项研究，以评估患者是否能够基于内部线索或内部加外部血糖线索学会更准确地“感觉”/辨别自己的血糖水平。在研究I中，相对于对照组，血糖意识训练显著提高了治疗前至治疗后的血糖估计准确性。研究II重复了血糖意识训练在提高血糖估计准确性方面的效果。估计准确性的提高仅与初始准确性有关；那些最初准确性较低的人提高幅度最大。这种提高表现为危险血糖估计误差减少31%，准确估计增加9%。然而，在训练结束时，最终的估计仍然明显不如自我血糖监测准确。
