30%低碳水化合物饮食治疗2型糖尿病的效果研究  

Effects of a 30%Low-carbohydrate Diet on Patients with Type 2 Diabetes

作　　者：曾婷[1] 林楚慧[1] 叶小芳[1] 邓宇虹[1] ZENG Ting;LIN Chuhui;YE Xiaofang;DENG Yuhong(Department of Clinical Nutrition,the Second Affiliated Hospital of Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院临床营养科,广东省广州市510260

出　　处：《中国全科医学》2020年第16期2030-2033,共4页Chinese General Practice

基　　金：广州市医药卫生科技项目(20171A010305)。

摘　　要：背景我国糖尿病患病率不断上升,需要有效且能坚持的饮食干预方式,以达到控制血糖的目的。低碳水化合物饮食可能使2型糖尿病患者受益,但目前仍存在争议。目的评估30%低碳水化合物饮食治疗2型糖尿病的效果。方法选取2017年5月—2018年10月于广州医科大学附属第二医院临床营养科门诊就诊的32例未使用胰岛素治疗的2型糖尿病患者为研究对象。给予30%低碳水化合物的膳食模式干预,持续6个月。于治疗前和治疗后3、6个月监测患者的体质指数(BMI)、空腹胰岛素(INS)、空腹血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平,并统计治疗后6个月减药、停药患者例数。结果共有30例2型糖尿病患者完成了6个月的低碳水化合物饮食,完成率为93.8%(30/32),退出率为6.2%(2/32)。干预前后患者BMI、FBG、2 hPG、HbA1c、TG、LDL-C比较,差异有统计学意义(P<0.05)。进一步两两比较显示:与干预前相比,饮食干预3、6个月后,BMI、FBG、2 hPG、HbA1c、TG、LDL-C均有所下降,差异有统计学意义(P<0.05);与干预后3个月相比,干预后6个月FBG、2 hPG、HbA1c、TG水平降低,差异有统计学意义(P<0.05)。19例正在口服降血糖药物的患者,干预后6个月减药10例(52.6%),停药1例(5.2%),总减/停药率57.9%(11/19)。结论30%低碳水化合物饮食治疗3、6个月能够明显改善未使用胰岛素的2型糖尿病患者的血糖和血脂情况,减少/停止糖尿病药物使用,并有较好的治疗依从性,值得进一步长期实施并观察。Background With the increasing prevalence of diabetes in China,effective and consistent dietary interventions are needed to control the current situation of blood glucose level.Low carbohydrate diet may benefit type 2 diabetic patients,but it is still controversial.Objective To evaluate the effects of a 30%low-carbohydrate diet on patients with type 2 diabetes.Methods During period between May 2017 and October 2018,32 patients with type 2 diabetes mellitus who did not have history of using insulin were selected from the Department of Clinical Nutrition of the Second Affiliated Hospital of Guangzhou Medical University.Selected patients were prescribed with a 30%low-carbohydrate dietary intervention for six months.Patients were monitored for body mass index(BMI),fasting insulin(INS),fasting blood glucose(FBG),2 h postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)before and at third and sixth months of the intervention.The number of patients with reduction and withdrawal of drug usage after six months of intervention were obtained.Results A total of 30 patients with type 2 diabetes completed the 6-month low-carbohydrate diet with a completion rate of 93.8%(30/32)and a withdrawal rate of 6.2%(2/32).The difference of BMI,FBG,2 hPG,HbA1c,TG and LDL-C before and after the intervention were statistically significant(P<0.05).Further pair-wise comparison showed that BMI,FBG,2 hPG,HbA1c,TG and LDL-C decreased significantly after three and six months of dietary intervention(P<0.05).Compared with those at three months after intervention,the levels of FBG,2 hPG,HbA1c and TG decreased significantly at 6 months after intervention(P<0.05).After six months of intervention,10(52.6%)patients reduced their drug intake while 1(5.2%)patient withdrew drug intake among 19 patients who were taking oral hypoglycemic drugs,so the total reduction/withdrawal rate was 57.9%(11/19).Conclusion The three

关 键 词：糖尿病 2型 膳食 低碳水化合物 饮食疗法 治疗结果 

分 类 号：R587.1[医药卫生—内分泌] R459.3[医药卫生—内科学]