临床个性化营养指导对1型糖尿病患者转归的影响
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摘要
目的分析临床个性化营养指导对1型糖尿病患者转归的影响。方法选择98例1型糖尿病患者,按干预方式不同分为对照组和研究组各49例,对照组予以常规干预,研究组予以临床个性化营养指导干预。随访18个月,比较2组空腹血糖(FPG)、2 h血糖(2 hPG)、糖化血红蛋白(HbA_1c)、总胆固醇(TC)、低密度脂蛋白-C(LDL-C)、血糖控制率及临床转归。结果随访结束时,研究组和对照组FPG[(6.71±0.83)mmol·L~(-1)比(7.85±0.94)mmol·L~(-1)]、2 hPG[(8.41±1.12)mmol·L~(-1)比(9.37±1.65)mmol·L~(-1)]、HbA_1c[(6.60±0.81)%比(7.42±0.95)%]、TC[(5.11±0.59)mmol·L~(-1)比(5.52±0.61)mmol·L~(-1)]和LDL-C[(3.11±0.40)mmol·L~(-1)比(3.30±0.38)mmol·L~(-1)]比较差异有统计学意义(P<0.05或P<0.01)。研究组血糖控制率明显高于对照组(95.92%比75.51%,P<0.01),不良转归发生率低于对照组(12.24%比28.57%,P<0.05)。结论 1型糖尿病患者应用临床个性化营养指导的效果肯定,能够有效控制血糖,利于疾病转归。
Objective To analyze the impact of clinically personalized nutrition guidance on outcome in patients with type 1 diabetes.Methods A total of 98 cases of type 1 diabetes were randomly assigned to receive either conventional intervention(control group,n=49) or clinically personalized nutrition guidance(research group,n=49).Patients were followed up for 18 months.Fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA_1c),total cholesterol(TC),low density lipoprotein-C(LDL-C),blood glucose control rate and clinical outcome were compared between the two groups.Results After follow-up,the levels of FPG,2 hPG,HbA_1c,TC and LDL-C in research group were lower than those in control group((6.71±0.83)mmol·L~(-1) vs(7.85±0.94)mmol·L~(-1),(8.41±1.12)mmol·L~(-1) vs(9.37±1.65)mmol·L~(-1),(6.60±0.81)mmol·L~(-1) vs(7.42±0.95)mmol·L~(-1),(5.11±0.59)mmol·L~(-1) and(5.52±0.61)mmol·L~(-1) and(3.11±0.40)mmol·L~(-1) vs(3.30±0.38)mmol·L~(-1),respectively; P<0.05 or P<0.01).In addition,compared with conventional intervention,clinically personalized nutrition guidance increased the blood glucose control rate(95.92% vs 75.51%,P<0.01),and reduced the incidence of adverse outcomes(12.24% vs 28.57%,P<0.05).Conclusion Clinically personalized nutrition guidance can effectively control blood glucose and is conducive to the outcome in patients with type 1 diabetes.
Objective To analyze the impact of clinically personalized nutrition guidance on outcome in patients with type 1 diabetes.Methods A total of 98 cases of type 1 diabetes were randomly assigned to receive either conventional intervention(control group,n=49) or clinically personalized nutrition guidance(research group,n=49).Patients were followed up for 18 months.Fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hPG),glycosylated hemoglobin(HbA_1c),total cholesterol(TC),low density lipoprotein-C(LDL-C),blood glucose control rate and clinical outcome were compared between the two groups.Results After follow-up,the levels of FPG,2 hPG,HbA_1c,TC and LDL-C in research group were lower than those in control group((6.71±0.83)mmol·L~(-1) vs(7.85±0.94)mmol·L~(-1),(8.41±1.12)mmol·L~(-1) vs(9.37±1.65)mmol·L~(-1),(6.60±0.81)mmol·L~(-1) vs(7.42±0.95)mmol·L~(-1),(5.11±0.59)mmol·L~(-1) and(5.52±0.61)mmol·L~(-1) and(3.11±0.40)mmol·L~(-1) vs(3.30±0.38)mmol·L~(-1),respectively; P<0.05 or P<0.01).In addition,compared with conventional intervention,clinically personalized nutrition guidance increased the blood glucose control rate(95.92% vs 75.51%,P<0.01),and reduced the incidence of adverse outcomes(12.24% vs 28.57%,P<0.05).Conclusion Clinically personalized nutrition guidance can effectively control blood glucose and is conducive to the outcome in patients with type 1 diabetes.
引文
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[11] 王新颖.规范化营养支持治疗在临床中的应用:医学研究生的新知识拓展[J].医学研究生学报,2015,28(8):785-788.
[12] 薛长勇.临床营养研究进展[J].营养学报,2015,37(2):121-124.
[13] 叶景虹,钱梦华,邹弘,等.个体化临床营养治疗对糖尿病前期患者转归的影响及因素分析[J].中国慢性病预防与控制,2014,22(5):529-532.
[14] 吕丽芬,李小飒,刘向强,等.口服营养补充研究进展[J].现代生物医学进展,2015,15(18):3589-3592.
[15] 孙鹤贞.2型糖尿病血糖与血脂的相关性分析[J].检验医学与临床,2016,13(z1):376-377.
[16] 张倩,李际敏,李琳娜,等.不同糖化血红蛋白水平的新诊断2型糖尿病患者胰岛功能的临床观察[J].中国糖尿病杂志,2016,24(2):108-112.
[2] BERGER B,SETHE D,HILGARD D,et al.Design of a self-management program for children aged 6-12 years with type 1 diabetes mellitusat the community hospital herdecke,Germany[J].Complement Med Res,2017,24(4):255-263.
[3] 高纯,胡俊波.临床营养筛查与评估方法的现状与进展[J].临床外科杂志,2016,24(12):896-898.
[4] 陈博,熊茂明,孟翔凌.营养状况评估方法及营养支持指征的研究进展[J].安徽医学,2016,37(10):1305-1308.
[5] 林旭.我国基础营养研究进展与展望[J].营养学报,2015,37(3):222-225.
[6] 中华医学会糖尿病学分会.中国Ⅰ型糖尿病诊治指南:节选[J].糖尿病临床,2013,7(2):55-71.
[7] 中华医学会糖尿病学分会,中国医师协会营养医师专业委员会.中国糖尿病医学营养治疗指南:2013[J].中华糖尿病杂志,2015,10(2):73-88.
[8] AMBIGAPATHY J,SAHOO J,KAMALANATHAN S.Autoimmune hypoglycemia in type 1 diabetes mellitus[J].Indian Pediatr,2017,54(7):593-594.
[9] NUNES SILVA J G,NUNES V S,SCHWARTZ R P,et al.Impact of type 1 diabetes mellitus and celiac disease on nutrition and quality of life[J].Nutr Diabetes,2017,7(1):e239.
[10] 刘玉倩,杨雯茜,殷娟娟.运动营养研究的新进展[J].北京体育大学学报,2015,38(8):58-64,79.
[11] 王新颖.规范化营养支持治疗在临床中的应用:医学研究生的新知识拓展[J].医学研究生学报,2015,28(8):785-788.
[12] 薛长勇.临床营养研究进展[J].营养学报,2015,37(2):121-124.
[13] 叶景虹,钱梦华,邹弘,等.个体化临床营养治疗对糖尿病前期患者转归的影响及因素分析[J].中国慢性病预防与控制,2014,22(5):529-532.
[14] 吕丽芬,李小飒,刘向强,等.口服营养补充研究进展[J].现代生物医学进展,2015,15(18):3589-3592.
[15] 孙鹤贞.2型糖尿病血糖与血脂的相关性分析[J].检验医学与临床,2016,13(z1):376-377.
[16] 张倩,李际敏,李琳娜,等.不同糖化血红蛋白水平的新诊断2型糖尿病患者胰岛功能的临床观察[J].中国糖尿病杂志,2016,24(2):108-112.