不同食物纠正老年糖尿病患者夜间低血糖的效果比较

Comparison of effects of different foods in correcting nocturnal hypoglycemia in elderly patients with diabetes mellitus

目的比较不同食物纠正老年糖尿病患者夜间低血糖的效果。方法采用便利抽样法,选取2019年1-10月于华中科技大学同济医学院附属协和医院住院期间发生夜间低血糖的115例老年糖尿病患者为研究对象,根据患者低血糖发生时采用的处理方法,将研究对象分为饼干组27例、含糖饮料组30例、糖块组32例及葡萄糖组26例,分别进食太平苏打饼干或嘉士利早餐饼4片、鲜橙多约138 g或农夫果园100%橙汁150 ml,德芙牛奶巧克力2块及口服50%葡萄糖溶液30 ml。采用指尖血糖检测4组患者发生低血糖时即刻血糖值、纠正后15 min血糖值及次日晨起空腹血糖值,于次日晨起空腹血糖检测完毕后采用低血糖食物满意度问卷调查患者对食物选择的满意度。结果葡萄糖组、糖块组及含糖饮料组低血糖纠正时间短于饼干组,葡萄糖组和糖块组纠正后15 min血糖值高于饼干组和含糖饮料组,差异均有统计学意义(P<0.05)。4组口感、饱腹感、携带便利性、纠正低血糖效果、对次日晨起血糖的影响、购买方便及需要进食其他食物的得分比较,差异均有统计学意义(P<0.05);饼干组饱腹感、对次日晨起血糖的影响得分高于其他3组,纠正低血糖效果、想进食其他食物的意向得分低于其他3组,差异均有统计学意义(P<0.05);含糖饮料组口感得分高于其他3组,差异有统计学意义(P<0.05);饼干组和糖块组携带便利性得分高于其他2组,差异有统计学意义(P<0.05);葡萄糖组购买便利性得分低于其他3组,差异有统计学意义(P<0.05)。结论饼干、含糖饮料、糖块及葡萄糖溶液均能纠正夜间低血糖,且对次日晨起血糖无影响,但含糖饮料、糖块及葡萄糖溶液升糖效果更好,而饼干在饱腹感、携带性、对次日晨起血糖影响等方面更让患者满意。因此,患者可根据个人喜好选择低血糖时应急食物。

Objective To compare effects of different foods in correcting nocturnal hypoglycemia in elderly patients with diabetes.Methods A total of 115 elderly patients with diabetes mellitus who had nocturnal hypoglycemia during hospitalization in Union Hospital,Tongji Medical College,Huazhong University of Science and Technology from January to October 2019 were selected as research objects.According to the treatment method adopted when hypoglycemia occurred,they were divided into 27 cases in the biscuit group,30 cases in the sugared beverage group,32 cases in the candy bar group and 26 cases in the glucose group.They respectively ate 4 pieces of Taiping soda biscuits or Jiashili breakfast cakes,about 138 g of fresh orange or 150 ml of 100%orange juice of Nongfu Orchard,2 pieces of Dove milk chocolate and 30 ml of oral 50%glucose solution.Fingertip blood glucose test was used to detect the immediate blood glucose level when hypoglycemia occurred,the blood glucose level of 15 min after correction and the fasting blood glucose level in the next morning in the 4 groups.After the fasting blood glucose test was completed the next morning,the patients'satisfaction with food choices was investigated using a low-glycemic food satisfaction questionnaire.Results The time of hypoglycemia correction was shorter in the glucose group,the candy bar group and the sugared beverage group than in the biscuit group.The glycemic values of the glucose group and the candy bar group at 15 min after correction were higher than those of the biscuit group and the sugared beverage group.The differences were statistically significant(P<0.05).The differences of taste,satiety,convenience of carrying,effect of correcting hypoglycemia,influence on blood glucose in the next morning,convenience of purchasing and need to eat other food score were statistically significant(P<0.05).The scores of satiety,influence on blood glucose in the next morning in the biscuit group were higher than those in the other 3 groups,and the scores of effect of correcting hypoglycemia and needing to eat other foods were lower than those in the other 3 groups,and the differences statistically significant(P<0.05).The taste score of sugared beverage group was higher than that of the other 3 groups,and the difference was statistically significant(P<0.05).The convenience of carrying score of the biscuit group and the candy bar group was higher than the other two groups,and the difference was statistically significant(P<0.05).The convenience of purchasing score of the glucose group was lower than the other 3 groups,and the difference was statistically significant(P<0.05).Conclusions Biscuits,sugared beverages,candy bars and glucose solutions can all correct nocturnal hypoglycemia and have no effect on blood sugar in the next morning.However,sugared beverages,candy bars and glucose solutions have a better effect on raising blood sugar,while biscuits are more satisfying for patients in terms of satiety,portability and the effect on blood sugar in the next morning.Therefore,patients can choose emergency food in case of hypoglycemia according to personal preference.