Lane J D, McCaskill C C, Ross S L, Feinglos M N, Surwit R S
Department of Psychiatry, Duke University Medical Center, Durham, NC 27710.
Diabetes Care. 1993 Aug;16(8):1087-94. doi: 10.2337/diacare.16.8.1087.
To examine the benefits of relaxation training for patients with NIDDM and to investigate individual differences that could predict a positive response to relaxation training.
Thirty-eight subjects with NIDDM were treated with intensive conventional diabetes therapy after an initial metabolic evaluation and psychological and pharmacological testing. Half were assigned to also receive biofeedback-assisted relaxation training. Treatment effects on GHb levels and glucose tolerance were evaluated after 8 wk.
Subjects demonstrated significant improvements in GHb level, but not in glucose tolerance, after 8 wk of intensive conventional treatment. These improvements persisted throughout the follow-up period. However, the group provided with relaxation training did not experience greater improvements on either measure than the group given conventional diabetes treatment only. Within the group that received relaxation training, correlations occurred between the improvements in glucose tolerance after treatment and individual differences in trait anxiety and in the effect of alprazolam on glucose tolerance. Differences in the effects of EPI on glucose tolerance and personality measures of neuroticism and perceived locus of control also appeared to be related to improvements in glucose tolerance after training.
Relaxation training did not confer added benefit over and above that provided by conventional diabetes treatment for patients with NIDDM. Additional research is needed to determine whether the administration of relaxation training to selected patients, especially those who are most responsive to stress, would provide benefits for glucose control that are not achieved by conventional treatment.
探讨放松训练对非胰岛素依赖型糖尿病(NIDDM)患者的益处,并研究能够预测对放松训练产生积极反应的个体差异。
38名NIDDM患者在进行初始代谢评估以及心理和药物测试后,接受强化常规糖尿病治疗。其中一半患者还被安排接受生物反馈辅助放松训练。8周后评估治疗对糖化血红蛋白(GHb)水平和葡萄糖耐量的影响。
经过8周强化常规治疗后,患者的GHb水平有显著改善,但葡萄糖耐量没有改善。这些改善在整个随访期持续存在。然而,接受放松训练的组在这两项指标上的改善并不比仅接受常规糖尿病治疗的组更大。在接受放松训练的组中,治疗后葡萄糖耐量的改善与特质焦虑的个体差异以及阿普唑仑对葡萄糖耐量的影响之间存在相关性。肾上腺素(EPI)对葡萄糖耐量的影响以及神经质和感知控制源的人格测量差异似乎也与训练后葡萄糖耐量的改善有关。
对于NIDDM患者,放松训练并未带来超过常规糖尿病治疗的额外益处。需要进一步研究以确定对选定患者,尤其是那些对压力反应最敏感的患者进行放松训练,是否能提供常规治疗无法实现的血糖控制益处。