高抗性淀粉主食对住院2型糖尿病患者血糖波动的影响

Effects of High Resistant Starch Staple Food on Blood Glucose Fluctuation in Hospitalized Patients with Type 2 Diabetes Mellitus

目的:探索高抗性淀粉主食对住院2型糖尿病患者血糖波动的影响。方法:选取本院内分泌科2型糖尿病住院患者102例,均由医院给予个性化的医学营养治疗(MNT)。试验共3d,试验第2~3天午餐和晚餐用等热量高抗性淀粉主食替代普通米饭;连续3d监测患者三餐前后和睡前血糖值;分析监测点平均血糖变化、血糖波动指标及低血糖发生次数。结果:试验期间早餐前后平均血糖无明显改变,差异无统计学意义(P>0.05);试验第3天午餐前后血糖值低于前2d血糖值,且午餐后血糖值随试验天数有下降趋势;试验第3天晚餐前后血糖值均低于第1天血糖值;试验第2天、3天睡前血糖值均低于第1天血糖值,差异具有统计学意义(P<0.05);试验期平均血糖逐日下降,差异有统计学意义(P<0.05);试验第3天血糖波动指标明显降低,较试验前差异有统计学意义(P<0.05);试验期间低血糖发生次数减少。结论:含高抗性淀粉主食替代普通米饭可以改善患者监测点平均血糖水平、降低血糖波动及减少低血糖发生次数,为改善糖尿病血糖控制、合理选择主食提供临床依据。

Objective To explore the effect of high-resistant starch staple food on blood glucose fluctuation in hospitalized patients with type 2 diabetes mellitus(T2DM). Method A total of 102 inpatients with type 2 diabetes mellitus were selected from the department of endocrinology,all patients were treated with individualized medical nutrition therapy(MNT).The experimental period was 3 days.On the 2nd to 3rd day,the staple food of lunch and dinner were replaced to isocaloric high resistant starch rice.Daily monitoring the patient s blood glucose for 3 days in a raw,including the blood glucose before and after meals of three postprandial and pre-bed time.The change of the average of blood glucose,blood sugar fluctuation index and the frequency of hypoglycemia were analyzed. Result During the experiment,there was no significant change in the average blood glucose before and after breakfast( P >0.05).The blood glucose value before and after lunch on the 3rd day was lower than that on the first two days,and tended to decrease with the test days after lunch.The blood glucose value before and after dinner on the 3rd day was lower than that on the 1st day.The pre-bed time blood glucose on the 2nd and 3rd day was lower than that on the 1st day( P <0.05).The average blood glucose decreased day by day during the experimental period( P <0.05).The blood sugar fluctuation index were significantly decreased on the 3rd day of the experiment,the difference was statistically significant compared with that before the experiment( P <0.05).The frequency of hypoglycemia were decreased. Conclusion The substitution of high resistant starch staple food for common rice can improve the average blood glucose level,reduce the fluctuation of blood glucose and reduce the frequency of hypoglycemia,which provides clinical basis for improving the control of blood glucose in diabetes mellitus and reasonable selection of staple food.