含缓释淀粉的肠内营养剂对T2DM餐后血糖的影响

Effect of Enteral Nutrition with Slow-Release Starch on Postprandial Blood Glucose of Type 2 Diabetes

目的通过含缓释淀粉的肠内营养剂与阿卡波糖、普通肠内营养剂对2型糖尿病患者餐后血糖影响的比较研究,探讨含缓释淀粉的肠内营养剂部分或全部代替降糖药的可能性。方法30例2型糖尿病患者,采用双周期交叉设计的自身对照方法比较食用精白馒头、食用精白馒头和阿卡波糖50mg、食用等能量的糖尿病专用肠内营养剂安素益力佳SR以及食用等能量非糖尿病专用的普通肠内营养剂的餐后2h血糖。结果食用精白馒头和阿卡波糖50mg、食用安素益力佳SR的餐后2h血糖,均明显低于食用精白馒头的餐后2h血糖(P<0.01),也低于食用普通肠内营养剂的餐后2h血糖(P<0.05),服用阿卡波糖与安素益力佳SR的餐后2h血糖之间无显著性差异(P>0.05),食用精白馒头与普通肠内营养剂的餐后2h血糖之间无显著性差异(P>0.05)。结论含缓释淀粉的肠内营养剂对餐后血糖的控制效果与阿卡波糖相近,比普通肠内营养剂更适合糖尿病患者使用。

Objective To compare the effects of enteral nutrition with slow-release starch, simple enteral nutrition and Acarbose on postprandial blood glucose of type 2 diabetic patients, and discuss the possibility of replacing all or part of the antidiabetic drugs by enteral nutrition with SR starch. Methods In this cross-over and self-control study, 30 cases of type 2 diabetic patients had different kinds of breakfast for four days. White steamed bread for the first day, isocaloric simple eternal nutrition for the second day were used, white steamed bread with 50mg Acarbose for the third day and isocaloric enteral nutrition with SR starch （Glucema SR 85g） for the forth day. Then exchange Glucema SR and Acarbose in the next week.Postprandial glucose of four days were compared. Results 2h PBG of bread with 50mg Acarbose and bread with Glucema SR 85g were much lower than that of white steamed bread（P〈 0.01）, and lower than simple enteral nutrition（P〈 0.05）; no difference was found between 2h PBG of Acarbose and Glucerna（P 〉 0.05 ）, 2h PBG of white steamed bread and simple enternal nutrition had no significant difference（P 〉 0.05 ）. Conclusion Enteral nutrition with SR starch has the same effect for controlling postprandial glucose as Acarbose. It is more suitable for type 2 diabetic patients than simple enteral nutrition.