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The evaluation of three treatment strategies in subjects with type I diabetes mellitus undergoing intensive diabetes management : metabolic, psycho-social and educational implications

Three approaches, differing in flexibility of self-adjustments of insulin to food intake & exercise, have been identified in intensive management of Type I diabetes mellitus. They involve the exchange system (Protocols A/B) & carbohydrate counting (Protocol C) dietary strategies. The goal of this cross-over study was to determine differences among the approaches in terms of metabolic control (primarily glycated hemoglobin-GHb) and psycho-social adaptation (quality of life (QofL), self-efficacy (SE), stress & perceived complexity) in 15 adults with insulin-dependent diabetes. / There were no significant differences in terms of metabolic control, self-efficacy and quality of life. Perceived complexity increased (p $<$ 0.0001) as subjects progressed from protocols A to C (least to most flexible). However, the subjects continued with Protocol B (n = 12) or Protocol C (n = 3) at the end of the study. Subjects who were very accurate in their self-monitoring of blood glucose (SMBG) reporting were also accurate in counting carbohydrate (p $<$ 0.001), more confident (SE) in their ability to adjust their insulin (p $<$ 0.05) and more satisfied (QofL) with their diabetes (p $<$ 0.01). / This study indicated that patients who are not ready to undertake carbohydrate counting need not be excluded from intensive management programs. Accuracy in SMBG reporting can be used to direct educational efforts.
Date January 1996
CreatorsKalergis, Maria.
ContributorsYale, Jean-Francois (advisor)
PublisherMcGill University
Source SetsLibrary and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
CoverageMaster of Science (School of Dietetics and Human Nutrition.)
RightsAll items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated.
Relationalephsysno: 001538793, proquestno: MM19824, Theses scanned by UMI/ProQuest.

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