2型糖尿病患者主食结构和自我调控能力对血糖控制影响的研究

Effects of staple food structure and self-regulation on blood glucose control in patients with type 2 diabetes mellitus

目的运用潜在剖面探讨T2DM患者主食结构特征,分析不同主食结构与血糖控制、自我效能的关系。方法使用北京市社区卫生服务中心现场调查数据,采用问卷调查、体格测量、生化检测的方法收集资料。结果基于不同血糖生成指数(GI)的主食用量构成比潜在剖面分析,将患者分为高GI占主食64.8%为高GI组(HGI)及占35.2%主食结构均衡组(BSF)。两组在性别(t=24.204,P<0.001)、年龄(t=-4.102,P<0.001)、吸烟(χ^(2)=21.640,P<0.001)及饮食方面自我效能得分(t=-3.515,P<0.001)差异有统计学意义。HbA1c达标率BSF组高于HGI组(41.0%vs33.7%)(P=0.049)。Logistic回归分析显示,DM病程、用药情况、主食结构是HbA1c达标率的影响因素。结论T2DM患者主食结构可分为高GI主食为主和主食结构均衡两类。临床应提高对男性、年轻、吸烟患者的饮食行为干预,提高自我效能,自发选择健康饮食。

Objective To investigate the characteristics of staple food structure by using latent profile analysis in patients with type 2 diabetes mellitus(T2 DM)and its relationship with blood glucose control and selfefficacy.Methods Based on the onsite survey conducted by Beijing community health service centers,data were collected using questionnaire surveys,physical measurements,and biochemical tests.Results The patients were divided into two groups based on the potential profile analysis of the ingredients of staple food:the group taking high glycemic index(GI)food(HGI group,64.8%)and the group taking balanced staple food(BSF group,35.2%).Gender(t=24.204,P<0.001),age(t=-4.102,P<0.001)and smoking status(χ^(2)=21.640,P<0.001)distributed different in two groups.Comparing with HGI group,patients taking balanced food had higher scores of dietary selfefficacy(t=-3.515,P<0.001)and higher reachingtarget rate(41.0%vs 33.7%)of HbA1 c(P=0.049).Logistic regression analysis showed that DM duration,drug use and staple food structure were the influencing factors of HbA1 c compliance rate.Conclusion The staple food structure of patients with T2 DM can be divided into two types:HGI group and BSF group.In men,younger and smoking T2 DM patients,lifestyle interventions should be strengthened to improve patients’selfefficacy.