碳水化合物计数法在2型糖尿病临床实践中的作用

Application of modified carbohydrate counting on glycemic control in type 2 diabetes

目的探讨碳水化合物计数法对2型糖尿病患者血糖控制的意义。方法选取141例2型糖尿病患者,依据随机数字表分为碳水化合物计数法组(研究组)和食物交换份组(对照组)。研究组采用碳水化合物计数法的热量交换份,确定每日碳水化合物的份数;对照组采用传统食物交换份法+血糖负荷指数进行指导。除饮食干预外,两组临床治疗均无差别对待。观察人体成分各项指标和血糖相关监测指标变化。结果研究组中途失访或退出7例,对照组失访3例。干预1周后,组间餐后血糖差异有统计学意义[(10.33±4.92)mmol/L比(12.71±2.95)mmol/L,t=3.34,P=0.00];干预3周后,两组间空腹血糖、血清胰岛素水平差异有统计学意义[(6.02±1.51)mmol/L比(7.33±2.46)mmol/L,(10.29±4.66)mmol/L比(13.95±10.31)mmol/L,均P<0.05)],此外研究组糖化血红蛋白、腰臀比和基础代谢也均有显著改善。结论碳水化合物计数法在2型糖尿病患者的血糖、血清胰岛素水平以及内脏脂肪面积控制方面均优于传统食物交换份法。

Objective To evaluate the effect of modified carbohydrate counting on glycemic control in type 2 diabetes. Method 141 patients who diagnosed with diabetes were enrolled. All the cases were randomly divided into Carbohydrate counting groups( study group) and food exchange copies group( control group). In addition to dietary intervention,the Clinical treatment are non-discriminatory. The alteration of body composition and glucose monitoring were recorded. Results A total of 141 patients were included in the study. 7 cases were lost or quit halfway in carbohydrate counting group and 3 cases in control group. There was no statistical difference in Baseline data before intervention.There was significant difference between carbohydrate counting group and control group on postprandial glucose after a week[( 10. 33 ± 4. 92) mmol/L VS.( 12. 71 ± 2. 95) mmol/L,t = 3. 34,P = 0. 00]. Similar differences were also observed in serum insulin levels and fasting blood glucose between two groups[( 6. 02 ± 1. 51) mmol/L VS.( 7. 33 ± 2. 46)mmol/L,( 10. 29 ± 4. 66) mmol/L VS.( 13. 95 ± 10. 31) mmol/L,P < 0. 05) ]. Waist-hip ratio and basal metabolism also improved significantly. Conclusion There are benefit from carbohydrate counting on glycemic control and body weight in patients with type 2 diabetes.