综合干预对2型糖尿病控制作用的研究  被引量:16

Integrated intervention in management of type 2 diabetes

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作  者:陈艳秋[1] 孙建琴[1] 孙皎[2] 宗敏[1] 陈敏[1] 汤丽新[1] 冯颖[1] 胡婷[3] 徐建华 杜陆原 邹伟 赵慧萍 

机构地区:[1]复旦大学附属华东医院营养科,上海200041 [2]复旦大学附属华东医院内分泌科,上海200041 [3]上海汽轮机有限公司 [4]上海电机有限公司 [5]上海江川社区卫生服务中心

出  处:《中华内分泌代谢杂志》2010年第3期199-202,共4页Chinese Journal of Endocrinology and Metabolism

基  金:国家自然科学基金(30371221);上海市科委项目(034119855),志谢感谢美国雅培公司为本课题提供糖尿病专用的低GI食物(益力佳SR)、血糖仪及血糖试纸;感谢中华医学会健康风险管理专业委员会王燕芳博士;感谢上海汽轮厂、上海电机厂、上海江川社区卫生服务中心和华东医院检验科诸位医师的大力支持和配合;感谢上海复旦大学医学院及上海职工医学院实习同学的参与;感谢营养科同仁的协助,感谢他们的通力合作使本课题得以顺利完成

摘  要:目的应用低血糖指数膳食,联合糖尿病健康教育、饮食指导和自我监测,探讨其对改善2型糖尿病患者糖代谢的效果。方法随机抽取体重指数(BMI)≥24kg/m^2的超重糖尿病患者150例,按2:1的比例分配至试验组和对照组,对照组的受试者仅接受包括运动和常规饮食指导的糖尿病健康教育。而试验组受试者除此以外还接受低血糖指数(glycemic index,GI)膳食指导,每天食用低GI的早餐替代食物(200kcal),每周定期进行至少6次的自我血糖监测。试验周期为24周,分别于试验开始、第12周和第24周进行基线、中期和终期的问卷调查及相关指标检测。结果基线时,试验组和对照组的能量、蛋白质、脂肪、碳水化合物和膳食GI均无明显差异(P〉0.05),通过糖尿病健康教育和饮食指导,试验组第12周和第24周,蛋白质、脂肪和膳食GI明显低于基线时(P〈0.01)。试验组的BMI、腰围、臀围、收缩压、舒张压较试验前均有明显降低(P〈0.01),其中腰围、臀围、收缩压、舒张压试验组明显低于对照组(P〈0.05)。与此同时,试验组和对照组第12周的空腹血糖分别下降16.5%、10.6%,第24周时试验组下降10.4%,对照组反而上升2.8%(P〈0.01)。两组在第12周时胰岛素抵抗指数分别下降24.2%、24.9%;第24周时试验组仍下降25.0%,对照组反而上升5.9%(P〈0.01),试验组第12周、24周的HbA1c也分别下降8.2%和11.1%。然而,对照组则分别上升0.7%和1.1%(P〈0.01)。结论2型糖尿病患者在综合干预措施后,空腹血糖和HbA1c水平明显改善,说明综合管理包括食用糖尿病专用的膳食替代食物(低GI食物)、糖尿病教育和定期的血糖监测在糖尿病治疗和控制中是有效的。Objective To test the effectiveness of an integrated intervention to improve control and management of type 2 diabetic patients. Methods The study was designed as a randomized and multi-center clinic trial for 24 weeks. 150 overweight patients from 2 companies and one hospital in Shanghai were recruited. The principal objective of the project was to compare the effectiveness of a structured diabetes management program consisting of 200 kcal breakfast as a meal replacement with low glycemic index (GI), scheduled blood glucose monitoring(6 times per week) ,low GI diet consulting, monitoring and medical check up and nutritional education (diet consulting, health education on nutrition and healthy lifestyle) in overweight individuals with type 2 diabetes. Results At 12 th week, the level of fasting blood glucose (FBG) in both groups decreased by 16.5 % and 10.6% , and at 24th week, the FBG also decreased by 25.0% in intervention group, but in control group FGB increased 2.8% (P〈0. 01 ). Meanwhile, there were 8.2% and 11.1% reductions in HbA1c respectively at 12th week and at 24th week in intervention group, while the values were increased slightly in control group( P〈0. 01 ). Compared with control group, waist circumference, hip circumference, and blood pressure were significantly reduced after treatment for 24 weeks in intervention group(P〈0. 01 ). Conclusions Integrated intervention is an effective approach in managing FBG,HbA1c ,blood pressure, and weight control in overweight diabetic patients.

关 键 词:综合干预 低血糖指数 糖尿病  2型 

分 类 号:R587.1[医药卫生—内分泌]

 

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