个体化营养护理干预改善2型糖尿病病人糖脂代谢的探讨

Investigation of individualized nutrition nursing intervention on glucose and lipid metabolism in patients with type 2 diabetes mellitus

目的:探讨个体化营养护理干预对2型糖尿病病人糖脂代谢的影响。方法:对300例糖尿病病人制订个体化营养护理干预方案,包括专题讲座、小组讨论、个体化指导、发放宣传手册以及营养专业评价,分别检测干预前后病人体重指数(BMI)、腰围、肱三头肌皮褶厚度、舒张压以及空腹和餐后2 h血糖、糖化血红蛋白、果糖胺以及三酰甘油和总胆固醇的变化。结果:干预后病人BMI、腰围、肱三头肌皮褶厚度、舒张压均明显下降,与干预前比有显著性差异(P﹤0.05);空腹和餐后2 h血糖、糖化血红蛋白、果糖胺亦明显下降,与干预前比有显著性差异(P﹤0.05)。病人C肽较干预前明显升高(P﹤0.05)。干预后病人的高胰岛素血症得到明显改善,胰岛素抵抗指数明显下降(P﹤0.05),三酰甘油和总胆固醇均较干预前明显下降(P﹤0.05)。结论:个体化的营养护理干预能明显改善糖尿病病人的糖脂代谢,临床应加强营养护理的建设和管理。

Objective： To investigate the effect of individualized nutrition nursing intervention on glucose and lipid metabolism in patients with type 2 diabetes mellitus. Methods： The individualized nutrition nursing intervention measures were taken in 300 cases of diabetes mellitus, such as special lecture, group discussion, individualized instruction, issuing brochures and nutrition evaluation. The body mass index（BMI）, the waist, three triceps skinfold thickness, diastolic pressure, fasting plasma glucose, 2 hours postprandial blood glucose, glycated hemoglobin, fructosamine, triglyceride and total cholesterol were measured before and after the intervention. Results： After the intervention, the BMI, waist, three triceps skinfold thickness and diastolic pressure were lower than before（P 〈 0.05 ）. The C peptide rised by 44.0%. After the intervention, the hyperinsulinism of patients were improved obviously, the triglyceride dropped from （ 2.74 ＋ 0.87 ） mmol/L to （ 2.01 _＋ 0.45 ） mmol/L and total cholesterol dropped from （5.65 ＋ 0.98） mmol/L to （4.23 ＋ 0.34） mmol/L. Conclusion ： It has important significance to taken the individual nutrition nursing intervention in the glucose and lipid metabolism of patients with diabetes mellitus. The construction and management of clinical nutrition nursing should be strength- ened.