不同膳食替代对超重2型糖尿病患者的影响

Effects of different meal replacement on overweight patients with type 2 diabetes

目的 探讨部分膳食替代（PMR）和完全膳食替代（CMR）对超重2型糖尿病患者血糖控制及生活质量的影响.方法 以在天津市大港油田总医院糖尿病科门诊就诊的超重2型糖尿病患者60例作为研究对象,按照随机数字法分为对照组、CMR组和PMR组,干预3个月.CMR组每天采用特殊膳食完全替代早餐,PMR组每天3餐前服用少量特殊膳食,并适当减少正餐量.采用酶比色法检测HbAl c,计算稳态模型评估-胰岛素抵抗指数（HOMA-IR）、体重指数,通过问卷调查了解糖尿病痛苦情况及生活质量.结果 研究结束后,与对照组相比,CMR组和PMR组HbA1c[（7.6±0.7）％比（8.2±0.8）％,（7.7±0.4）％比（8.2±0.8）％]、HOMA-IR[（4.3±1.2）比（6.0±2.0）,（4.7±1.4）比（6.0±0.2）]均明显降低（P均＜0.05）.PMR组与CMR组相比,在改善糖尿病痛苦[（25.9±2.8）比（27.7±2.4）]及生活质量[（73.8±4.1）比（70.2±4.2）]方面具有明显的优势（P均＜ 0.05）.结论 PMR在改善糖、脂代谢的效果与CMR相当,但PMR更有利于减轻尿病患者的心理压力,提高其生活质量.

Objective To test effects of partial meal replacement （PMR and complete meal replacement（CMR） on glycemic control and quality of life in overweight patients with type 2 diabetes.Methods Outpatients with type 2 diabetes and overweight were screened in department of diabetes,general hospital of Tianjin dagang oilfield.Finally,60 cases were in the study.The subjects were divided into control group,CMR group and PMR group to receive intervention for three months according to method of random number.Special dietary completely replaced daily breakfast in CMR group,while in PMR group,a small amount of special dietary was taken before three meals a day,and daily meals were reduced,appropriately.HbA1c was examined by enzymatic colorimetric.Homeostasis model assessment insulin resistance （HOMAIR） and body mass index were assessed.Diabetes-related distress and quality of life were conducted by questionnaires.Results At the end of the study,CMR group showed statistically differences in glycemic control [（7.6 ± 0.7） ％ vs.（8.2 ± 0.8） ％] and HOMA-IR [（4.3 ± 1.2） vs.（6.0 ± 0.2）],compared with control group（all P ＜ 0.05）,the same as PMR group compared to control group [（7.7 ± 0.4） ％ vs.（8.2 ±0.8）％,P ＜0.05;（4.7 ± 1.4） vs.（6.0 ±0.2）,P ＜0.05] ; Compared with CMR group,the effects of PMR group on reducing diabetes-related distress and improving quality of life were significant [（25.9 ± 2.8） vs.（27.7±2.4）,P＜0.05;（73.8±4.1） vs.（70.2 ±4.2）,P＜0.05）.Conclusion The effects of PMR on improving glycemic and lipid control showed no obvious advantage relative to CMR,while it was priority to reduce diabetes-related emotional stress and improve quality of life in diabetic patients.