McCulloch D K, Young R J, Steel J M, Wilson E M, Prescott R J, Duncan L J
Hum Nutr Appl Nutr. 1983 Aug;37(4):287-92.
One hundred and seventy eight insulin dependent diabetics (IDDM) have been studied regarding their understanding of and compliance with a controlled carbohydrate diet. Forty per cent could not remember their dietary prescription, 35 per cent did not estimate carbohydrate and many scored badly in a 'quiz' on the carbohydrate content of common foods. Quiz scores were significantly associated with HbA1 levels (P less than 0.001). One hundred and thirty six patients completed a seven-day food record from which the pattern of eating was established. Of these 75 were injecting twice daily short and intermediate acting insulin; in this group there were significant relationships between HbA1 and both care with carbohydrate estimation and eating pattern (P less than 0.05). Thus, in IDDM, the understanding of a controlled carbohydrate diet and adherence to it are associated with better glycaemic control but adequate compliance is rare. Future dietary recommendations for insulin taking diabetics should be simple, easy to understand, acceptable in practice and of proven effectiveness if they are to appreciably influence the quality of diabetic control.
对178名胰岛素依赖型糖尿病患者（IDDM）进行了关于他们对碳水化合物控制饮食的理解和依从性的研究。40%的患者记不住他们的饮食处方，35%的患者不会估算碳水化合物含量，并且许多患者在关于常见食物碳水化合物含量的“小测验”中得分很低。测验得分与糖化血红蛋白（HbA1）水平显著相关（P<0.001）。136名患者完成了一份为期七天的饮食记录，据此确定了饮食模式。其中75名患者每日注射两次短效和中效胰岛素；在这组患者中，HbA1与碳水化合物估算的关注度和饮食模式之间均存在显著关系（P<0.05）。因此，在IDDM中，对碳水化合物控制饮食的理解和坚持与更好的血糖控制相关，但充分的依从性很少见。如果要显著影响糖尿病控制质量，未来针对注射胰岛素的糖尿病患者的饮食建议应该简单、易懂、在实践中可行且已被证明有效。
