Influence of imaginative teaching of diet on compliance and metabolic control in insulin dependent diabetes.
Influence of imaginative teaching of diet on compliance and metabolic control in insulin dependent diabetes.
复制标题
富有想象力的饮食教学对胰岛素依赖型糖尿病依从性和代谢控制的影响。
DOI：
10.1136/bmj.287.6408.1858
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发表时间：
1983
期刊：
影响因子：
--
通讯作者：
Bsc D MITCHELL
中科院分区：
文献类型：
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作者：
D. K. McCULLOCH;R. D. Mitchell;J. Ambler;R. B. Tattersall;Bsc D MITCHELL
饮食不依从是胰岛素依赖型糖尿病代谢控制不良的重要原因。病人常被指责，但教学方法可能有问题，因此，一项前瞻性研究，以比较三种不同的教学方法的效果。经过三个月的磨合，40名长期控制不佳的胰岛素依赖型糖尿病（平均血红蛋白A1 13.0%）的成年人被随机分配到三种教学方法：传统的饮食单指令（组1），实际午餐时间示范（组2），录像带教育（组3）。通过问卷调查评估知识，通过7天食物记录评估依从性，通过连续糖化血红蛋白测量评估血糖控制。在6个月的随访中，第1组的知识、依从性或HbA1没有改善，但第2组和第3组的知识和依从性都有所改善。第2组HbA1降至10.6（SD 2.1）%，第3组降至9.6（2.3）%。HbA1的变化显示出与饮食依从性（通过碳水化合物摄入的每日一致性判断）的明显相关性。这些研究结果表明，新的和有趣的教育方法可以对胰岛素依赖型糖尿病的知识，依从性和代谢控制产生重大影响。
Dietary non-compliance is an important cause of poor metabolic control in insulin dependent diabetes. Patients are often blamed, but teaching methods may be at fault, so a prospective study was set up to compare the effect of three different teaching methods. After a three month run in, 40 adults with longstanding poorly controlled insulin dependent diabetes (mean haemoglobin A1 13.0%) were allocated at random to three teaching methods: conventional diet sheet instruction (group 1); practical lunchtime demonstrations (group 2); videotape education (group 3). Knowledge was assessed by questionnaires, compliance by seven day food records, and glycaemic control by serial glycosylated haemoglobin measurements. During six months of follow up there was no improvement in knowledge, compliance, or HbA1 in group 1, but in groups 2 and 3 both knowledge and compliance improved. In group 2 HbA1 fell to 10.6 (SD 2.1)% and in group 3 to 9.6 (2.3)%. The change in HbA1 showed an appreciable correlation with dietary compliance as judged by day to day consistency in carbohydrate intake. These findings show that new and interesting educational methods can have a major influence on knowledge, compliance, and metabolic control in insulin dependent diabetes.