PubMed · 8516646
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A Elinskas. 1993. B-G-T-E-S-T: a basic review.. https://pubmed.ncbi.nlm.nih.gov/8516646/
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The influence of narcissistic regulation on metabolic control was investigated in 130 patients with Type-II-diabetes in the course of a rehabilitation programme. Two groups were studied: a) diabetics on a non-drug therapy regimen, b) diabetics treated by insulin. At the end of the rehabilitation programme 55.6% of the non-insulin patients and 60.1% of the insulin treated patients exhibited a clinically significant improvement as measured by HbA1c. On the basis of the Düsseldorf Questionnaire for Narcissistic Regulation in Chronic Disease (DNACE) predictors of metabolic control were established. Using decision analysis, a correct prediction was possible in 73.1% resp. 85.4% of the cases. In the non-drug group, low values of the "helplessness/powerlessness" scale and high values of the "mourning" scale predicted an improvement of metabolic control at the end of the rehabilitation programme. On the other hand, in the insulin treated group the more successful patients were shown to have low values in the scales "distrust", "feeling of being ashamed of disease", "feeling of inferiority" and "fighting self-image" and high values in the scales "value ideal" and "symbiotic protection of the self". The results are discussed within the theoretical framework.
The postpartum period in women with diabetes or GDM allows both the physician and mother to relax from the intensive medical and obstetric management that has permitted, in most cases, a successful and joyous outcome. The role of the physician, however, must switch to a proactive and preventive mode to formulate a reproductive health plan for women with diabetes and GDM. The plan should be individualized to address glycemic management and surveillance, nutritional management, contraception prescription, future pregnancy planning, and lifestyle changes. Essential to the development of a reproductive health plan is the active participation of the patient, who through education gains an understanding of the far-reaching effects her active participation will have on her subsequent health and possibly on that of her future children.
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