2型糖尿病医学营养治疗临床指南执行现状定量研究分析  

A survey on the status of implementation of MNT clinical guidelines for type 2 diabetes mellitus

作　　者：方京徽[1] 刘雯[2] 张红 于淼 李响 李金[5] 刘鹏举[1] 于洁芳 于康[1] FANG Jinghui;LIU Wen;ZHANG Hong(Clinical Nutrition Department of Beijing Union Medical College Hospital,Beijing 100730,China)

机构地区：[1]北京协和医院临床营养科,100730 [2]首都医科大学附属北京同仁医院临床营养科 [3]北京市平谷区慢病防治与老年学学会临床营养专业委员会 [4]中国医学科学院阜外医院营养科 [5]北京市大兴区人民医院营养科 [6]北京市王府医院营养科

出　　处：《中国糖尿病杂志》2023年第11期815-820,共6页Chinese Journal of Diabetes

摘　　要：目的调查北京市各级医院T2DM患者医学营养治疗(MNT)临床指南执行现状和对于DM前期IR和代谢免疫营养干预情况。方法2022年11~12月对北京市58家医院营养科和内分泌科以定量问卷方式,调查MNT临床指南执行现状。结果参与调查的医院T2DM患者MNT指南执行比例为86%,83%的医师对T2DM患者进行“营养饮食评估和诊断”,执行人以营养师为主(84%),主要使用营养风险筛查量表进行营养筛查(97%),“IR评估”的比例为70%,新近评估及推荐在T2DM患者日常管理控制方面占比较低,仅29%的医生推荐使用“甜味剂”,38%的医生采用“免疫干预”进行辅助治疗,70%的医生推荐使用免疫营养物质,但对于能干预IR的免疫相关营养物质的认识有明显差异。结论北京市各级医院T2DM患者MNT临床指南执行需要改善,应加大培训和落实MNT在T2DM临床治疗的执行。Objective To evaluate the implementation of medical nutrition therapy(MNT)clinical guidelines in patients with type 2 diabetes mellitus(T2DM),and the nutritional intervention of insulin resisitance(IR)and immuno-nutrition in prediabetes in medical institutions at all levels in Beijing.Methods From November to December 2022,we investigated the implementation of MNT in the nutrition and endocrine departments of 58 hospitals in Beijing using quantitative questionnaires.Results The implementation rate of MNT guidelines for patients with T2DM was 86%in medical institutions at all levels in Beijing.A total of83%of doctors conducted“nutritional diet assessment and diagnosis”for T2DM patients.Nutritionists(84%)were the main executors of nutritional screening,and the NRS 2002 scale(97%)was mainly used for nutritional screening,the proportion of“IR assessment”is 70%,emerging assessments and recommendations account for a relatively low proportion in the daily management and monitoring of patients with T2DM,only29%of doctors recommend that patients use“sweeteners”,and 38%of doctors use“immune intervention”for adjuvant treatment,70%of the doctors recommended immune nutrients for patients with T2DM.Conclusion The implementation of MNT clinical guidelines for patients with T2DM need to be improved in medical institutions at all levels in Beijing.

关 键 词：医疗机构 糖尿病 2型 医学营养治疗临床指南 执行率 胰岛素抵抗 

分 类 号：R587.1[医药卫生—内分泌]