系统思维方法在2型糖尿病综合治疗中的应用

分析系统方法主要基本原则在2型糖尿病治疗中的指导性作用。揭示在医学科学研究中自觉,主动运用辩证法思维方法和系统科学方法,可以拓展研究的新思路,为糖尿病的治疗提供更好方案。     

线粒体在糖尿病发生发展中作用的再评价

糖尿病作为一种线粒体疾病,已成为世界面临的重大健康问题,线粒体医学的发展,大大推进了对糖尿病病因及病理机制的认识,为糖尿病的干预拓宽了道路,基于线粒体糖尿病与2型糖尿病病因的不同,对线粒体糖尿病的诊断与治疗也不同。     

脂肪细胞因子与2型糖尿病的防治

脂肪细胞因子与2型糖尿病并发症关系密切,随着对胰岛素抵抗(IRS)在2型糖尿病作用的认识,脂肪细胞因子的提出,使2型糖尿病并发症防治观念发生了根本的转变,提出了2型糖尿病并发症关防治新策略:从以降糖治疗为主到全面综合防治。对脂肪细胞因子和脂肪细胞因子与2型糖尿病并发症的关系的认识,体现了循证医学的思想和创新思维的启动。     

系统思维在糖尿病防治中的应用

随着人们生活水平的提高,糖尿病日益成为威胁人类健康的主要疾病。在整体观的指导下,人们对于糖尿病采取综合全面的治疗。同时,整体优化的原则在防治中被充分运用。近年来,我国建立了2型糖尿病发病因素分析方式与概率预测模型。     

Predictors of the Peer Acceptance of Children with Diabetes: Social Behavior and Disease Severity

Objective. Investigated illness severity (medical control, disease impact, obviousness) and social behavior style as predictors of the peer acceptance of children with diabetes. Method. Sixty-five children (10–12.5 years old) with diabetes and their parents, teachers, and physicians participated. Physician ratings and laboratory tests indicated medical control. Parents and children reported disease impact and teachers rated disease obviousness. Children and teachers rated social behavior. Teachers reported peer acceptance. Results. Consistent with hypotheses, favorable social behavior positively predicted acceptance and disease impact negatively predicted acceptance; medical control did not relate to acceptance. Disease obviousness and social behavior interacted to predict acceptance. Children with more obvious disease were not stigmatized by unfavorable social behavior. Conclusions. Aspects of disease severity and social behavior influence peer acceptance and may be appropriate predictors and targets for remediation of peer problems.     

Use of Multisystemic Therapy to Improve Regimen Adherence Among Adolescents with Type 1 Diabetes in Poor Metabolic Control: A Pilot Investigation

The purpose of the current study was to conduct a pilot investigation to determine the effectiveness of Multisystemic Therapy (MST) for improving regimen adherence and metabolic control among adolescents with poorly controlled Type 1 diabetes. Thirty-one adolescents were randomly assigned to either MST or a control condition. MST treatment lasted approximately six months. Data were collected at study entry and at a six-month posttest. Twenty-five adolescents completed the study. Adolescents who received MST had significantly improved adherence to blood glucose testing and metabolic control from study entry to the six-month posttest, whereas controls did not. Adolescents receiving MST also had a decreased number of inpatient admissions at the six-month posttest. Improvements in metabolic control were related to improvements in parent report of adolescent adherence. Results suggest that MST holds promise as an intervention for improving adherence behavior and health outcomes among adolescents in poor metabolic control.     

Association of Depression with Complications of Diabetic Pregnancy: A Retrospective Analysis

The goal of this study was to determine whether an association between histories of depression and adverse pregnancy outcome could be established using a retrospective analysis. Participants were a convenience sample of 152 pregnant diabetic women for whom prior pregnancy data were available. Prior pregnancy outcome, depression history, and other clinical characteristics were determined from chart review and medical history questionnaires. Logistic regression was used to determine which of the measured clinical factors, including history of depression, had a significant association with history of pregnancy complications. Thirty-nine patients (26%) had a past history of depression. Three pregnancy complications (preterm labor, pre-eclampsia, fetal prematurity) were more common in the group having a history of depression as was the proportion of participants requiring Caesarean section p( < .05 for each comparison). A history of depression was associated with prior pregnancy complications independent of the effects of parity, prepregnancy BMI, tobacco use history, diabetes type, and presence of diabetes complications (OR = 3.6; 95% CI = 1.5–9.0, p = .006). These retrospective data indicate that depression is linked to complications of diabetic pregnancy and support the need for prospective studies to clarify the effects of depression and its treatment on diabetic pregnancy.     

控制糖尿病的新观念和基本方略之管见

跟踪糖尿病发展趋势、吸收新理论和新技术、做好科普宣传、推行超强化治疗、坚持医学理性精神是控制糖尿病的新观念.其基本方略就是超强化治疗、控制高血压,拮抗新生2型糖尿病及其并发症、控制相关危险因素.     

The Diabetes Family Behavior Checklist: A Psychometric Evaluation

The Diabetes Family Behavior Checklist (DFBC) assesses supportive and non-supportive parental behavior specific to diabetes management via parent and child reports. The DFBC was administered to 133 children with type 1 diabetes (T1D) and their caregivers. Subsequent analysis verified the two-factor structure of the DFBC corresponding to positive and negative support behaviors. Internal consistency was high for DFBC scores. Moderate to strong correlations with other measures of diabetes-specific familial behaviors, adherence, and metabolic control support the validity of the DFBC. Clinical application of the DFBC is discussed.     

Effects of a checklist on self-assessment of blood glucose level by a memory-impaired woman with diabetes mellitus

This study evaluated effects of a checklist on the accuracy of self-assessment of blood glucose level by a diabetic woman with memory impairments caused by viral encephalitis. The checklist consisted of 54 steps for operating an electronic glucometer, which the subject performed in sequence and checked off when completed. Following introduction of the checklist, the percentage of steps completed correctly increased in simulated and actual blood glucose tests and yielded clinically useful information.