Rudolf M C, Ahern J A, Genel M, Bates S, Harding P, Hochstadt J, Quinlan D, Tamborlane W V
Diabetes Care. 1982 May-Jun;5 Suppl 1:53-7.
The psychosocial effects of recent advances in the management of diabetes mellitus are unknown and could conceivably be adverse, particularly during the critical period of adolescence. Seven teenagers were evaluated by standard psychosocial scales and a detailed questionnaire before and on completion of a 6-mo intensive management program utilizing home glucose monitoring and multiple injections or the insulin infusion pump. All achieved improved metabolic control with inpatient glucose values (during 24-h monitoring) falling from 244 +/- 58 to 108 +/- 10 mg/dl, glycosylated hemoglobin levels falling from 11.8 +/- 2.9% to 8.4 +/- 1.7%, and home glucose levels averaging 121 +/- 16 mg/dl. Standardized scales evaluating depression, diabetic adjustment, self-esteem, and social adjustment indicated no deterioration in psychosocial functioning. There was a statistically significant increase in locus of control scores, suggesting an improved sense of internal control of life events. The program questionnaire revealed a positive response to both the program and the control devices used. This study suggests that the positive metabolic benefits of intensive diabetic management during adolescence are not offset by adverse psychosocial effects and indeed positive psychosocial benefits may result.
糖尿病管理方面近期进展所产生的社会心理影响尚不清楚，并且可以想象可能是不利的，尤其是在青春期这个关键时期。在一项为期6个月的强化管理项目开始前及结束时，使用家庭血糖监测和多次注射或胰岛素输注泵，通过标准社会心理量表和详细问卷对7名青少年进行了评估。所有人的代谢控制均得到改善，住院期间的血糖值（24小时监测）从244±58降至108±10mg/dl，糖化血红蛋白水平从11.8±2.9%降至8.4±1.7%，家庭血糖水平平均为121±16mg/dl。评估抑郁、糖尿病适应、自尊和社会适应的标准化量表显示社会心理功能没有恶化。控制点得分有统计学意义的增加，表明对生活事件的内部控制感有所改善。项目问卷显示对该项目和所使用的控制设备都有积极反应。这项研究表明，青春期强化糖尿病管理带来的积极代谢益处不会被不利的社会心理影响所抵消，而且确实可能会产生积极的社会心理益处。
