连续血糖监测评价水煮或油煎饺子对糖尿病患者餐后血糖的影响

Effect of boiled and fried dumplings on postprandial blood glucose in diabetes patients assessed by continuous glucose monitoring

目的采用连续血糖监测（CGM）方法评价水煮或油煎饺子对糖尿病患者餐后血糖的影响。方法纳入10例2011年2至5月在北京协和医院内分泌科住院的2型糖尿病患者，佩戴胰岛素泵平稳控制其空腹与餐前血糖，试验期内第2和第4天午餐分别给予油煎或水煮饺子，试验饮食的营养含量相同。利用抗性淀粉体外消化方法测定试餐的可消化淀粉中快}肖化淀粉与持续消化淀粉含量，以及抗性淀粉含量。试验阶段佩戴CGM记录全天血糖变化，观察试验餐对餐后各时点（0、15、30、60、90、120、150、180、240min）血糖、峰值血糖、分时段（0～60min、63～120min、123～180min、183～240min）血糖曲线下面积（AUC）的影响。结果体外消化法测定油煎方法的快消化淀粉含量低于水煮方法（30．8％和77．0％）；油煎方法持续消化淀粉含量高于水煮方法（67．3％和20．7％），两种试餐中抗性淀粉含量均不高（1．9％和2．3％）。而油煎方法餐后血糖峰值出现时间早于水煮方法[（93±53）min比（156±61）min，P=0．02]。各时点血糖均值差异无统计学意义，各时段血糖AUC差异无统计学意义（均P〉0．05）。结论水煮方法淀粉消化速度快，但餐后血糖峰值却晚于油煎方法，油煎饺子对2型糖尿病患者升高血糖的作用比水煮方法更早。

Objective To compare two different dumping cooking methods （boiling vs. frying） in their effect on postprandial glucose level in diabetic patients using continuous glucose monitoring （ CGM ）. Methods 10 type 2 diabetes mellitus （T2DM） in-patients in the Department of Endocrinology of Peking Union Medical College Hospital between February and May 2011 were enrolled, whose fasting and preprandial glucose levels were controlled with a insulin pump. On day 2 and day 4 in the study period, the patients were given fried dumplings and boiled dumplings for lunch respectively, with the same nutrient contents. The starch digestibility of these two kinds of dumplings were compared using in vitro resistant starch digestion, measuring the concentrations of rapidly digestible starch, slowly digestible starch, and resistant starch. CGM was used to record blood glucose changes, in order to evaluate glycemic effect of these two dumpling cooking methods on postprandial glucose levels at 9 time points （0, 15, 30, 60, 90, 120, 150, 180, and 240 mi- nutes） , peak blood glucose, and area under the curve （AUC） in 4 time periods （0 -60, 63 - 120, 123 -180, and 183 -240 minutes）. Results The percentage of rapidly digestible starch was remarkably lower in fried dumplings than in boiled dumplings （30.8% vs. 77.0% ） , but the content of slowly digestible starch in fried dumplings was higher than that in boiled ones （63.7% vs. 20.7% ）, and the content of resistant starch in both dumplings were similarly low （ 1.9% and 2.3% ）. The average time to the peak glucose value was shorter in fried dumplings compared with boiled dumplings [ （93 ± 53） minutes vs. （156± 61 ） minutes, P = 0.02 ], but the average glucose levels at all the 9 time points and the AUC in all the 4 time periods were not significantly different （ all P 〉 0.05 ）. Conclusions Compared with fried dumplings, boiled dumplings show faster starch digestion, but long time to the peak postprandial glucose level. Fried dumplings may raise the glucose level faster than boiled dumplings do in T2DM patients.