不同医学营养治疗对老年2型糖尿病患者血糖波动性的影响

Effect of different medical nutrition therapy on blood glucose fluctuation in elderly type 2 diabetes mellitus patients

目的探讨不同医学营养治疗方法对老年2型糖尿病患者血糖波动性的影响。方法将85例2型糖尿病患者按完全随机分组法分为3组,对照组29例、低血糖生成指数(GI)膳食组27例、水溶性膳食纤维组29例,3组均参照中国糖尿病医学营养治疗指南给予糖尿病膳食指导,并给予口服降糖药,低GI膳食组早晚餐完全用低GI膳食替代,水溶性膳食纤维组在早、晚餐时各添加水溶性膳食纤维10g。干预期为1个月,干预前后观察各组患者血糖、血脂、肾功能及血糖波动情况。结果与干预前比较,各组干预后血糖均有不同程度下降(P<0.05),低GI膳食组及水溶性膳食纤维组干预后血糖波动性指标明显下降(P<0.05)。与对照组比较,干预后低GI膳食组空腹血糖平均值、餐后血糖平均值、血糖平均值明显下降(P<0.05),干预后低GI膳食组和水溶性膳食纤维组血糖标准差、平均血糖波动幅度明显低于对照组(P<0.05)。结论老年2型糖尿病患者在糖尿病膳食指导及口服药物治疗基础上,给予低GI膳食替代治疗或添加水溶性膳食纤维,能有效控制血糖水平,明显降低血糖的波动性。

Objective To investigate the effects of different medical nutrition therapy on blood glucose variability in elderly patients with type 2diabetes.Methods Eighty-five patients with type 2diabetes were randomly divided into three groups,29 cases in the control group,27 cases in the low GI diet group,29 cases in water-soluble dietary fiber group.Each patient was established a individuality diabetic diet recipe according to the guidelines of medical nutrition therapy,combined with oral hypoglycemic agents,The breakfast and dinner for patients in low GI diet group were completely instead of low GI diet,while the breakfast and dinner for patients in water-soluble dietary fiber group were added 10 g dietary fiber.Blood glucose,blood lipid,renal function and blood glucose fluctuation were observed before and after one-month intervention.Results Compared with before intervention,the concentration of blood glucose after the intervention in each group were decreased（P〈0.05）,the glucose fluctuation index in low GI diet group and water soluble dietary fiber group decreased obviously after the intervention（P〈0.05）.After the intervention,average fasting blood glucose,postprandial glucose average,and mean blood glucose in low GI diet group were significantly lower than those in control group（P〈0.05）,Meanwhile,the blood sugar standard deviation and MAGE in low GI dietary intervention group and in water-soluble dietary fiber group were significantly lower than that of control group（P〈0.05）.Conclusion On the basis of the diabetes diet recipes and oral drug treatment giving low GI dietary replacement therapy or adding water soluble dietary fiber,for elderly patients with type 2diabetes,could effectively control the blood glucose level,and significantly reduce glucose variability.