联合低血糖生成指数及低血糖生成负荷饮食干预对2型糖尿病患者糖脂代谢的影响

Effect of low glycemic index and low glycemic load diet intervention on glucose and lipid metabolism in patients with type 2 diabetes mellitus

目的：评价联合低血糖生成指数（ LGI ）及低血糖生成负荷（ LGL ）的饮食干预对社区2型糖尿病（T2DM）患者血糖血脂代谢指标的影响。方法整群随机抽取湖南省长沙市金盆岭三真社区内三个不同小区，分别在各小区内随机抽取已确诊的T2DM且符合本研究纳入标准的35例患者为研究对象，将三个小区以抽签的形式随机分为全天饮食干预组（A组）、早餐饮食干预组（B组）及对照组（C组）。通过3个月分组干预，即保持患者原治疗方案不变的情况下，指导A组患者一日三餐采用LGI及LGL的食物，B组仅早餐采用LGI及LGL的食物，而C组饮食不作要求，比较干预前后三组患者空腹血糖（FBG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）、甘油三酯（TG）、总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）指标的变化。符合正态分布的计量资料比较采用单因素的方差分析。结果多个独立样本比较Kruskal-Wallis H检验显示，干预前后三组的 HbA1c 均有改善（均 P ＜0.05），其中 A 组 HbA1c 改善优于 B、C 组（H ＝26.749，P ＜0.0167）；干预前后三组的HDL-C均有所下降（均P＜0.05），其中A组患者的HDL-C下降幅度大于B组及C组（H＝12.671，P＜0.0167）；干预前后三组的TG均有改善（均P＜0.05），其中A组、B组的TG改善优于C组（H＝14.921，P＜0.0167）。结论联合LGI及LGL饮食干预能有效改善T2DM患者HbA1c、HDL-C及TG，其中全天饮食干预较早餐饮食干预更有效。

Objective To evaluate the effects of combined low glycemic index （ LGI ） and low glycemic load （ LGL） diet intervention on glucose and lipid metabolism in community patients with type 2 diabetes mellitus （ T2DM）.Methods A total of 105 patients with T2DM were enrolled from 3 different communities in Changsha city in this study , 35 T2DM patients in each community with met inclusion criteria.The three communities were randomly divided into the whole day diet intervention group （ group A）, breakfast intervention group （B group） and control group （group C） by draw lots.The patients with T2DM in group A and group B received 3 months combined LGI and LGL diet intervention at the basis of keeping the original regimen.All the subjects in the study were tested fasting blood glucose （FBG）, 2-hour postprandial blood glucose （2 hPG）, glycosylated hemoglobin （HbA1c）, triglyceride （TG）, total cholesterol （ TC ） , high density lipoprotein-cholesterol （ HDL-C ） and low density lipoprotein-cholesterol＆amp;nbsp;（ LDL-C ） before and after dietary intervention.The quantitative data obeying normal distribution were compared with one-way analysis of variance.Results Multiple independent sample Kruskal-Wallis H test showed that the HbA1c of three groups improved after the intervention （all P〈0.05）, and it was better in group A than that in group B and C （H=26.749, P〈0.0167）.The HDL-C in the three groups decreased significantly after the intervention （ all P〈0.05） , and it decreased further in group A than that in group B and C （H =12.671,P 〈0.0167）.The metabolism of TG in patients with T2DM of the three groups improved significantly when compared with those before intervention （ all P 〈0.01 ） , and it was better in group A and B than that in group C （H=14.921, P〈0.05）.Conclusion Combined LGI and LGL diet intervention can effectively improve HbA 1c, HDL-C and TG of the patients with T2DM, especially the whole day diet intervention is more effective than only breakfast diet intervention.