Seigler D E, LaGreca A, Citrin W S, Reeves M L, Skyler J S
Diabetes Care. 1982 May-Jun;5 Suppl 1:19-23.
We studied the psychological effects of a program of intensification of glycemic control, using three different insulin regimens: (1) twice-daily regular and lente insulin; (2) multiple preprandial doses of regular insulin coupled with long-acting ultralente insulin; and (3) continuous subcutaneous insulin infusion (CSII). Ten patients used each of the regimens for periods of 2 mo. Patients monitored blood glucose 4-7 times daily. Using the Hopkins Symptom Checklist, there were significant reductions in depression, interpersonal sensitivity, and anxiety during all three treatment programs. Self-concept scores were more positive following CSII therapy. Positive self-concept ratings were correlated with positive attitudes about diabetes, medical care, persons with diabetes, and current diabetes regimens. After all subjects had experienced CSII, self-concept was positively related to attitudes regarding the insulin pump. Patients reporting more positive attitudes toward their current diabetes regimens had lower glycosylated hemoglobin levels. Thus, there were no adverse psychological effects of blood glucose monitoring, intensification of therapy, or use of infusion pumps by the parameters measured.
我们采用三种不同的胰岛素治疗方案，研究了强化血糖控制方案的心理效应：（1）每日两次的普通胰岛素和中效胰岛素；（2）多次餐前注射普通胰岛素并联合长效特慢胰岛素；（3）持续皮下胰岛素输注（CSII）。10名患者每种治疗方案均使用2个月。患者每天监测血糖4至7次。使用霍普金斯症状清单，在所有三个治疗方案期间，抑郁、人际敏感和焦虑均显著减轻。CSII治疗后自我概念得分更为积极。积极的自我概念评分与对糖尿病、医疗护理、糖尿病患者和当前糖尿病治疗方案的积极态度相关。在所有受试者都体验过CSII后，自我概念与对胰岛素泵的态度呈正相关。对当前糖尿病治疗方案报告有更积极态度的患者糖化血红蛋白水平较低。因此，根据所测量的参数，血糖监测、强化治疗或使用输液泵均未产生不良心理影响。
