Peterson C M, Jones R L, Dupuis A, Levine B S, Bernstein R, O'Shea M
Diabetes Care. 1979 Jul-Aug;2(4):329-35. doi: 10.2337/diacare.2.4.329.
An attempt was made to improve the control of blood glucose in patients with insulin-dependent diabetes mellitus. Ten patients were studied over a period exceeding 8 mo in the outpatient department. Each patient was taught to monitor his or her own blood glucose concentration and was enrolled in an exercise program. In addition, they were taught to calibrate insulin, food, and exercise in terms of the response of the blood glucose. After 3 mo of study, there was a significant decrease in hemoglobin A1c (Hb A1c) values from a mean concentration of 10.3 to 7.6%. Hb A1c values correlated well with mean blood glucose levels (r = 0.86). Dietary analysis revealed that the patients selected a diet consisting of 25% protein, 44% fat, and 31% carbohydrate, but there was a wide range in caloric distribution. There was no correlation between blood glucose control as measured by Hb A1c and caloric distribution. Systolic blood pressures decreased greater than 10 mm Hg. Serum alkaline phosphatase also decreased in each patient as control of blood glucose improved. Three of the patients with abnormalities of nerve conduction measurement at the beginning of the study had a complete return to normal at 8 mo. An outpatient program such as this may be cost effective through the avoidance of diabetes-related hospitalizations and may provide a mechanism whereby larger studies can be designed to define further the relationship of glycemia to the sequelae of diabetes.
研究人员试图改善胰岛素依赖型糖尿病患者的血糖控制情况。在门诊对10名患者进行了为期超过8个月的研究。每位患者都学会了自行监测血糖浓度，并参加了一个运动项目。此外，他们还学会了根据血糖反应来调整胰岛素、饮食和运动。经过3个月的研究，糖化血红蛋白（Hb A1c）值从平均浓度10.3%显著降至7.6%。Hb A1c值与平均血糖水平相关性良好（r = 0.86）。饮食分析显示，患者选择的饮食中蛋白质占25%、脂肪占44%、碳水化合物占31%，但热量分布范围较广。通过Hb A1c衡量的血糖控制情况与热量分布之间没有相关性。收缩压下降超过10 mmHg。随着血糖控制的改善，每位患者的血清碱性磷酸酶也有所下降。研究开始时神经传导测量异常的3名患者在8个月时完全恢复正常。这样的门诊项目通过避免与糖尿病相关的住院治疗可能具有成本效益，并可能提供一种机制，据此可以设计更大规模的研究，以进一步明确血糖与糖尿病后遗症之间的关系。
