食物的血糖指数与糖尿病饮食治疗效果

Glycemic index of food and the effect of dietary treatment for diabetes

目的:探讨等热量而血糖指数不同的食物对糖尿病患者血糖、血脂和胰岛素的影响。方法:①选择2003-06/2004-06在广州医学院第一附属医院内分泌科住院治疗的2型糖尿病患者73例,男40例,女33例。患者均知情同意。②在原药物治疗的基础上进行饮食治疗,试验期8周,经过2个饮食阶段。第1阶段:低血糖指数饮食阶段:食用血糖指数<55%的食物4周,经过15d清洗期后,进入第2阶段:血糖指数饮食阶段:食用血糖指数>75%的食物4周。所需食物的总热量按标准体质量计算。③分别于两个饮食阶段结束时测定患者血生化学指标:血脂检测采用比色法,果糖胺检测采用酮胺法,血糖用血糖仪检测,胰岛素用放射免疫学法检测,胰岛素曲线下面积犤0.25×空腹胰岛素±0.75×(餐后60min胰岛素)±0.5×(餐后60min胰岛素犦。④计量资料差异性比较采用t检验。结果:糖尿病患者73例均进入结果分析。8项指标:低血糖指数饮食阶段明显低于高血糖指数饮食阶段犤(6.8±1.2),(12.73±2.71),(10.26±1.92),(2.19±0.58),(1.9±0.2),(4.6±1.2)mmol/L,(75±25)mIU/(L·min),(68±22)mIU/L;(8.9±2.7),(14.81±2.77),(13.82±3.24),(4.10±0.67),(2.5±0.5),(7.0±0.3)mmol/L,(118±40)mIU/(L·min),(93±14)mIU/L,t=4.58～18.41,P<0.01犦;空腹高密度脂蛋白胆固醇、餐后2h高密度脂蛋白胆固醇:低血糖指数饮食阶段明显高于高血糖指数饮食阶段犤(1.4±0.4),(1.4±0.5)mmol/L;(1.2±0.4),(1.2±0.2)mmol/L,t=3.02,3.17,P<0.01犦。结论:低血糖指数饮食可改善糖尿病患者的血糖、血脂和胰岛素抵抗状态,糖尿病患者应以低血糖指数饮食为主。

AIM： To probe into the influence of food of the same calorie but different glycemic index on the blood glucose, blood lipid and insulin of diabeticpatients. METHODS：①Seventy-three type 2 diabetic inpatients （40 males and 33 females） in the Department of Endocrinology, First Affiliated Hospital, Guangzhou Medical College between June 2003 and June 2004 took part in the study voluntarily. ②Based on drug treatment,an 8-week dietary treatment was given by 2 phases. The 1st phase （phase of low glycemic index food）： the food of glycemic index 〈 55% was taken for 4 weeks, and after a 15-day cleaning phase,entered the 2nd phase （phase of high glycemic index food）： the food of glyeemic index 〈 75% was taken for 4 weeks. The total calorie of the food was calculated according to the standard body mass.③ The blood biochemical indexes of the patients were detected at the ends of the two dietary phases respectively： blood lipid was detected with chromatometry, fructosamine with ketoamine method, blood glucose with blood glucose meter, insulin with radioimmunity, the area under curve of insulin =0.25×fasting insulin±0.75×（60-minute postprandialin-sulin）±0.5×（60-minute postprandial insulin）. ④ The difference of the mea-surement data was compared with the t test. RESULTS：All the 73 diabetic patients were involved in the analysis of results. The 8 indexes of fasting blood glucose, 1 and 2-hour postprandial blood glucose, fructosamine, 2-hour postprandial triglyceride, 2-hour postprandial cholesterol, area under curve of insulin and 2-hour postprandial insulin were obviously lower at the phase of low glycemic index than at the phase of high glycemic index [（6.8±1.2）, （12.73±9.71）,（10.26±1.92）, （2.19±0.58）,（1.9±0.2）, （4.6±1.2） mmol/L, （75±25） mIU/L, per minute, （68±22） mI-U/L;（8.9±2.7）,（14.81 ±2.77）,（13.82±3.24）,（4.10±0.67）,（2.5±0.5）,（7.0±0.3） mmol/L,（118±40） mIU/L per minute, （93±14） mIU/L, t=4.58 to 18.41, P 〈 0.01]. The fasting and 2-hour postprandial high density lipoprotein cholesterol were obviously higher at the phase of low glyeemic index than at the phase of high glycemic index [（1.4±0.4）, （1.4±0.5） mmol/L; （1.2±0.4）, （1.2±0.2） mmol/L, t=3.02, 3.17, P 〈 0.01]. CONCLUSION： Diet of low glycemic index can ameliorate the blood glu-cose, blood lipids and insulin resistance of the diabetic patients, so the di-abetic patients should mainly take diet of low glycemic index.