Peterson C M, Forhan S E, Jones R L
Diabetes Care. 1980 Jan-Feb;3(1):82-7. doi: 10.2337/diacare.3.1.82.
Patients have been shown to be able to monitor their blood glucose and administer insulin to optimize and normalize blood glucose levels. There are now three reflectance meters available whose measurements correlate well with laboratory measurement of blood glucose, with a correlation coefficient between 0.92 and 0.97. A stepwise approach toward blood glucose control has been found to be most valuable. The initial phase of the program involves patients performing blood glucose measurements before and 1 h after each meal, in addition to times when patients feel hypo- or hyperglycemic. This phase of the program demonstrates the vagaries of glucose control and emphasizes to the patients the dichotomy between symptoms and actual glucose levels. The patient is also taught during this period the risk factors associated with hyperglycemia that may contribute to vascular disease in the future. Subsequently, insulin is adjusted so that patients are given an insulin regimen that will coordinate peaks of insulin with peaks of blood glucose associated with a meal pattern. Patients are taught by health professionals and in a group setting to calibrate insulin calories and exercise depending on blood glucose readings. Such a program is received enthusiastically by patients and physicians. The major disadvantage lies in the cost of the meter and the reagent strips. Nevertheless, such programs may be cost effective because of the avoidance of diabetes-related hospitalizations.
已证明患者能够监测自己的血糖水平并注射胰岛素，以优化血糖水平并使其正常化。目前有三种反射式血糖仪，其测量结果与实验室血糖测量结果相关性良好，相关系数在0.92至0.97之间。已发现逐步控制血糖的方法最有价值。该计划的初始阶段要求患者在每餐前后以及感觉低血糖或高血糖时测量血糖。该计划的这一阶段展示了血糖控制的变幻莫测，并向患者强调了症状与实际血糖水平之间的差异。在此期间，还会向患者传授与高血糖相关的危险因素，这些因素可能会在未来导致血管疾病。随后，调整胰岛素剂量，以便为患者提供一种胰岛素治疗方案，使胰岛素峰值与与饮食模式相关的血糖峰值相协调。健康专业人员会在小组环境中教导患者根据血糖读数来校准胰岛素热量和运动量。这样的计划受到患者和医生的热烈欢迎。主要缺点在于血糖仪和试剂条的成本。然而，由于避免了与糖尿病相关的住院治疗，此类计划可能具有成本效益。
