Smith D E, Heckemeyer C M, Kratt P P, Mason D A
Department of Medicine, University of Alabama at Birmingham, School of Medicine, USA.
Diabetes Care. 1997 Jan;20(1):52-4. doi: 10.2337/diacare.20.1.52.
The aim of this randomized pilot study was to examine whether the addition of motivational interviewing strategies to a behavioral obesity intervention enhances adherence and glucose control in older obese women with NIDDM.
Twenty-two older obese women (41% black) with NIDDM were randomly assigned to 1) a standard 16-week group behavioral weight-control program that provided instruction in diet, exercise, and behavioral modification or 2) the same group behavioral program with three individualized motivational interviewing sessions added.
The motivational group attended significantly more group meetings (13.3 vs. 8.9), completed significantly more food diaries (15.2 vs. 10.1), and recorded blood glucose significantly more often (46.0 vs. 32.2 days) than the standard group. Further, participants in the motivational group had significantly better glucose control post-treatment (9.8 vs. 10.8%). Although both groups demonstrated significant weight loss, no differences were apparent between groups.
These results suggest that augmenting a standard behavioral treatment program for obese women with NIDDM with a motivational interviewing component may significantly enhance adherence to program recommendations and glycemic control. Preliminary data warrant further investigation with larger samples and a longer follow-up.
本随机试点研究旨在探讨在行为性肥胖干预中加入动机性访谈策略是否能提高老年非胰岛素依赖型糖尿病肥胖女性的依从性和血糖控制水平。
22名患有非胰岛素依赖型糖尿病的老年肥胖女性（41%为黑人）被随机分配到以下两组：1）一个为期16周的标准团体行为体重控制项目，该项目提供饮食、运动和行为改变方面的指导；2）同一个团体行为项目，但增加了三次个性化的动机性访谈环节。
与标准组相比，动机组参加团体会议的次数显著更多（13.3次对8.9次），完成食物日记的数量显著更多（15.2篇对10.1篇），记录血糖的频率也显著更高（46.0天对32.2天）。此外，动机组的参与者在治疗后血糖控制情况显著更好（9.8%对10.8%）。虽然两组均显示出显著的体重减轻，但两组之间没有明显差异。
这些结果表明，在针对患有非胰岛素依赖型糖尿病的肥胖女性的标准行为治疗项目中加入动机性访谈成分，可能会显著提高对项目建议的依从性和血糖控制水平。初步数据值得用更大的样本和更长的随访时间进行进一步研究。
