不同蛋白质含量膳食睡前加餐对老年2型糖尿病患者夜间低血糖的影响  

Impact of different protein composition of bedtime snack on prevention of nocturnal hypoglycemia in older patients with type 2 diabetes mellitus

作　　者：刘丽珺[1] 韩燕霞[1] 蒋青[1] 周雨雷 Liu Lijun;Han Yanxia;Jiang Qing;Zhou Yulei(Department of Endocrinology,The First Affiliated Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第一医院内分泌科,江苏苏州215000

出　　处：《护理学杂志》2024年第23期5-8,共4页Journal of Nursing Science

基　　金：苏州大学附属第一医院2023年周氏护理科研项目(HLYJ-Z-202303)。

摘　　要：目的探讨不同蛋白质含量膳食睡前加餐预防老年2型糖尿病患者夜间低血糖的效果,为老年糖尿病患者血糖安全管理提供依据。方法将300例老年2型糖尿病患者随机分为对照组和干预组各150例。以动态血糖监测系统监测睡前(22:00)血糖4.0~5.6 mmol/L为干预时机,对照组予进食饼干9 g(含1.3 g蛋白质),干预组采用100 mL温水冲泡奶粉20 g(含6.6 g蛋白质)。比较两组夜间低血糖发生率和睡前加餐后次日血糖达标情况。结果干预组夜间低血糖发生率为3.75%,对照组为12.50%,两组差异有统计学意义(P<0.05);干预组次日血糖波动幅度、血糖目标范围时间、血糖低于目标范围时间及其达标率显著优于对照组(均P<0.05)。结论提高蛋白质含量的睡前加餐方案可降低老年2型糖尿病患者夜间低血糖的发生,促进次日血糖达标。Objective To evaluate the impact of different protein composition of bedtime snack on prevention of nocturnal hypoglycemia in older patients with type 2 diabetes mellitus,and to provide reference for glucose management in this population.Methods Three hundred older patients were randomized to one of two groups,with 150 in each.Their glucose level at bedtime(22:00)was measured using a continuous glucose monitoring system and if it was between 4.0 and 5.6 mmol/L,9 g of low-protein biscuits(containing 1.3 g protein)were given for the control group,while high-protein substitutions(20 g of milk powder dissolved in 100 mL of water containing 6.6 g protein)were given for the intervention group.The incidence of nocturnal hypoglycemia and the next-day glucose levels were compared between the two groups.Results The incidence of nocturnal hypoglycemia was 3.75%in the intervention group and 12.50%in the control group,showing significant difference(P<0.05).The mean amplitude of glycemic excursion,time in range,time below range,as well as the rates of these parameters during the target range were significantly better in the intervention group compared with the control group(all P<0.05).Conclusion Consuming a high protein bedtime snack can effectively reduce the incidence of nocturnal hypoglycemia in older patients with type 2 diabetes and improve next-day glycemic control.

关 键 词：老年人 糖尿病 夜间低血糖 睡前加餐 血糖管理 蛋白质 营养素 饮食护理 

分 类 号：R473.5[医药卫生—护理学] R587.1[医药卫生—临床医学]