药物和膳食纤维相结合的糖尿病综合治疗
|
摘要
膳食纤维是2型糖尿病的发病和治疗过程中非常重要的健康元素,不仅能够降低糖尿病的发病率,同时还可以提高糖尿病的治疗效果。更值得注意的是,膳食纤维能够提高组织细胞对于胰岛素的敏感性,改善胰岛素抵抗,这为2型糖尿病的病因治疗提供了可能。因此,本文在现有的药物治疗为主、饮食治疗为辅的糖尿病基本方案中强化膳食纤维在糖尿病治疗中的作用,通过长时间的药物和膳食纤维相结合的综合治疗,力求实现部分糖尿病患者对胰岛素的敏感性恢复至正常水平,以期达到取消药物治疗的目的。
Dietary fibers are very important healthy elements in the pathogenesis and treatment of type 2 diabetes.They not only reduce the incidence of diabetes, but also improve the therapeutic effect of anti-diabetic drugs. Moreover, the most attractive point has been that dietary fibers increase the insulin sensitivity in the body and lead to an improvement of insulin resistance in diabetic patients, which provides the possibility of etiological treatment for type 2 diabetes. Therefore, this article focuses on the possibility of a long-term combination therapy of anti-diabetic drugs for blood glucose control and dietary fiber for the improvement of insulin resistance in type 2 diabetic patients, and pursuits an expectable recovery of the insulin sensitivity to the normal level, and achieves the withdraw of long-lasting drug treatment.
Dietary fibers are very important healthy elements in the pathogenesis and treatment of type 2 diabetes.They not only reduce the incidence of diabetes, but also improve the therapeutic effect of anti-diabetic drugs. Moreover, the most attractive point has been that dietary fibers increase the insulin sensitivity in the body and lead to an improvement of insulin resistance in diabetic patients, which provides the possibility of etiological treatment for type 2 diabetes. Therefore, this article focuses on the possibility of a long-term combination therapy of anti-diabetic drugs for blood glucose control and dietary fiber for the improvement of insulin resistance in type 2 diabetic patients, and pursuits an expectable recovery of the insulin sensitivity to the normal level, and achieves the withdraw of long-lasting drug treatment.
引文
[1]万星驿,李玲.抗2型糖尿病药物研究新进展[J].医学综述,2014,20(22):4133-4135.
[2]纪立农,陆菊明,郭晓蕙,等.中国2型糖尿病药物治疗现状与血糖控制的调查研究[J].中华糖尿病杂志,2012,4(7):397-401.
[3]Hopping BN,Erber E,Grandinetti A,et al.Dietary fiber,magnesium,and glycemic load alter risk of type 2 diabetes in a multiethnic cohort in Hawaii[J].The Journal of Nutrition,2009,109.112441.
[4]Salmerón J,Manson JE,Stampfer M J,et al.Dietary fiber,glycemic load,and risk of non-insulin-dependent diabetes mellitus in women[J].JAMA,1997,277(6):472-477.
[5]Schulze MB,Simin L,Rimm EB,et al.Glycemic index,glycemic load,and dietary fiber intake and incidence of type 2 diabetes in younger and middle-age women[J].American Journal of Clinical Nutrition,2004,80(2):348-356.
[6]Weng LC,Lee NJ,Yeh WT,et al.Lower intake of magnesium and dietary fiber increases the incidence of type 2diabetes in Taiwanese[J].Journal of the Formosan Medical Association,2012,111(11):651-659.
[7]刘健,冯翔,何影仪,等.广州地区新诊断的2型糖尿病膳食危险因素研究[J].中国糖尿病杂志,2012,20(1):10-13.
[8]向红丁,吴纬.全国14省市30万人口中糖尿病调查报告[J].中华内科杂志,1981,20(11):678-683.
[9]Xu Y,Wang L,He J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948-959.
[10]Miranda PM,Horwitz D L.High-fiber diets in the treatment of diabetes mellitus[J].Annals of Internal Medicine,1978,88(4):895-899.
[11]Hagander B,Asp NG,Efendi S,et al.Dietary fiber decreases fasting blood glucose levels and plasma LDL concentration in noninsulin-dependent diabetes mellitus patients[J].American Journal of Clinical Nutrition,1988,47(5):852-858.
[12]Post RE,Mainous AG,King D E,et al.Dietary fiber for the treatment of type 2 diabetes mellitus:A meta-analysis[J].The Journal of the American Board of Family Medicine,2012,25(1):16-23.
[13]Chandalia M,Garg A,Lutjohann D,et al.Beneficial effects of high dietary fiber intake in patients with type 2diabetes mellitus[J].New England Journal of Medicine,2000,342(19):1392-1398.
[14]王亚伟,王燕.膳食纤维对糖尿病人血糖的影响[J].食品工业科技,2001,22(5):25-27.
[15]田学森.膳食纤维低聚糖临床降糖降脂效果分析[J].中国慢性病预防与控制,2003,4:27.
[16]方京徽,徐芳,卢广荣,等.糖尿病营养治疗新方法的探索[J].中国糖尿病杂志,2009,17(3):197-198.
[17]连炬飞,夏燕琼,王挺,等.高膳食纤维干预对妊娠期糖尿病患者的疗效分析[J].国际检验医学杂志,2014,(19):2609-2610.
[18]Jiang J,Qiu H,Zhao G,et al.Dietary fiber intake is associated with Hb A1c level among prevalent patients with type 2 diabetes in Pudong New Area of Shanghai,China[J].Plo S One,2012,7(10):e46552.
[19]Pastors JG,Blaisdell PW,Balm TK,et al.Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes[J].American Journal of Clinical Nutrition,1991,53(6):1431-1435.
[20]Hgm L,Granfeldt YE,Ime B.Products based on a high fiber barley genotype,but not on common barley or oats,lower postprandial glucose and insulin responses in healthy humans[J].Journal of Nutrition,1996,126(2):458-466.
[21]Weickert MO,Mohlig M,Schofl C,et al.Cereal fiber improves whole-body insulin sensitivity in overweight and obese women[J].Diabetes Care,2006,29(4):775-780.
[22]Rave K,Roggen K,Dellweg S,et al.Improvement of insulin resistance after diet with a whole-grain based dietary product:Results of a randomized,controlled crossover study in obese subjects with elevated fasting blood glucose[J].British Journal of Nutrition,2007,98(5):929-936.
[23]Kim H,Stote KS,Behall KM,et al.Glucose and insulin responses to whole grain breakfasts varying in soluble fiber,β-glucan[J].European Journal of Nutrition,2009,48(3):170-175.
[24]White J,Jago R,Thompson JL.Dietary risk factors for the development of insulin resistance in adolescent girls:A 3-year prospective study[J].Public Health Nutrition,2014,17(2):361-368.
[25]Breneman CB,Tucker L.Dietary fibre consumption and insulin resistance-the role of body fat and physical activity[J].British Journal of Nutrition,2013,110(2):375-383.
[26]李晓月,楚素平,张晶晶,等.玉米皮膳食纤维对反式脂肪酸致小鼠胰岛素抵抗的影响[J].食品科学,2014,13:45.
[27]Cameron-Smith D,Habito R,Barnett M,et al.Dietary guar gum improves insulin sensitivity in streptozotocininduced diabetic rats[J].The Journal of Nutrition,1997,127(2):359-364.
[28]汤多山.高膳食纤维抗糖尿病作用及机制[J].安徽医药,2001,5(1):55-57.
[29]张文青,张月明.抗性淀粉对糖尿病大鼠胰岛素抵抗的影响[J].营养学报,2008,30(3):257-261.
[30]Liese AD,Schulz M,Fang F,et al.Dietary glycemic index and glycemic load,carbohydrate and fiber intake,and measures of insulin sensitivity,secretion and adiposity in the Insulin Resistance Atherosclerosis Study[J].Diabetes Care,2005,28(12):2832-2838.
[2]纪立农,陆菊明,郭晓蕙,等.中国2型糖尿病药物治疗现状与血糖控制的调查研究[J].中华糖尿病杂志,2012,4(7):397-401.
[3]Hopping BN,Erber E,Grandinetti A,et al.Dietary fiber,magnesium,and glycemic load alter risk of type 2 diabetes in a multiethnic cohort in Hawaii[J].The Journal of Nutrition,2009,109.112441.
[4]Salmerón J,Manson JE,Stampfer M J,et al.Dietary fiber,glycemic load,and risk of non-insulin-dependent diabetes mellitus in women[J].JAMA,1997,277(6):472-477.
[5]Schulze MB,Simin L,Rimm EB,et al.Glycemic index,glycemic load,and dietary fiber intake and incidence of type 2 diabetes in younger and middle-age women[J].American Journal of Clinical Nutrition,2004,80(2):348-356.
[6]Weng LC,Lee NJ,Yeh WT,et al.Lower intake of magnesium and dietary fiber increases the incidence of type 2diabetes in Taiwanese[J].Journal of the Formosan Medical Association,2012,111(11):651-659.
[7]刘健,冯翔,何影仪,等.广州地区新诊断的2型糖尿病膳食危险因素研究[J].中国糖尿病杂志,2012,20(1):10-13.
[8]向红丁,吴纬.全国14省市30万人口中糖尿病调查报告[J].中华内科杂志,1981,20(11):678-683.
[9]Xu Y,Wang L,He J,et al.Prevalence and control of diabetes in Chinese adults[J].JAMA,2013,310(9):948-959.
[10]Miranda PM,Horwitz D L.High-fiber diets in the treatment of diabetes mellitus[J].Annals of Internal Medicine,1978,88(4):895-899.
[11]Hagander B,Asp NG,Efendi S,et al.Dietary fiber decreases fasting blood glucose levels and plasma LDL concentration in noninsulin-dependent diabetes mellitus patients[J].American Journal of Clinical Nutrition,1988,47(5):852-858.
[12]Post RE,Mainous AG,King D E,et al.Dietary fiber for the treatment of type 2 diabetes mellitus:A meta-analysis[J].The Journal of the American Board of Family Medicine,2012,25(1):16-23.
[13]Chandalia M,Garg A,Lutjohann D,et al.Beneficial effects of high dietary fiber intake in patients with type 2diabetes mellitus[J].New England Journal of Medicine,2000,342(19):1392-1398.
[14]王亚伟,王燕.膳食纤维对糖尿病人血糖的影响[J].食品工业科技,2001,22(5):25-27.
[15]田学森.膳食纤维低聚糖临床降糖降脂效果分析[J].中国慢性病预防与控制,2003,4:27.
[16]方京徽,徐芳,卢广荣,等.糖尿病营养治疗新方法的探索[J].中国糖尿病杂志,2009,17(3):197-198.
[17]连炬飞,夏燕琼,王挺,等.高膳食纤维干预对妊娠期糖尿病患者的疗效分析[J].国际检验医学杂志,2014,(19):2609-2610.
[18]Jiang J,Qiu H,Zhao G,et al.Dietary fiber intake is associated with Hb A1c level among prevalent patients with type 2 diabetes in Pudong New Area of Shanghai,China[J].Plo S One,2012,7(10):e46552.
[19]Pastors JG,Blaisdell PW,Balm TK,et al.Psyllium fiber reduces rise in postprandial glucose and insulin concentrations in patients with non-insulin-dependent diabetes[J].American Journal of Clinical Nutrition,1991,53(6):1431-1435.
[20]Hgm L,Granfeldt YE,Ime B.Products based on a high fiber barley genotype,but not on common barley or oats,lower postprandial glucose and insulin responses in healthy humans[J].Journal of Nutrition,1996,126(2):458-466.
[21]Weickert MO,Mohlig M,Schofl C,et al.Cereal fiber improves whole-body insulin sensitivity in overweight and obese women[J].Diabetes Care,2006,29(4):775-780.
[22]Rave K,Roggen K,Dellweg S,et al.Improvement of insulin resistance after diet with a whole-grain based dietary product:Results of a randomized,controlled crossover study in obese subjects with elevated fasting blood glucose[J].British Journal of Nutrition,2007,98(5):929-936.
[23]Kim H,Stote KS,Behall KM,et al.Glucose and insulin responses to whole grain breakfasts varying in soluble fiber,β-glucan[J].European Journal of Nutrition,2009,48(3):170-175.
[24]White J,Jago R,Thompson JL.Dietary risk factors for the development of insulin resistance in adolescent girls:A 3-year prospective study[J].Public Health Nutrition,2014,17(2):361-368.
[25]Breneman CB,Tucker L.Dietary fibre consumption and insulin resistance-the role of body fat and physical activity[J].British Journal of Nutrition,2013,110(2):375-383.
[26]李晓月,楚素平,张晶晶,等.玉米皮膳食纤维对反式脂肪酸致小鼠胰岛素抵抗的影响[J].食品科学,2014,13:45.
[27]Cameron-Smith D,Habito R,Barnett M,et al.Dietary guar gum improves insulin sensitivity in streptozotocininduced diabetic rats[J].The Journal of Nutrition,1997,127(2):359-364.
[28]汤多山.高膳食纤维抗糖尿病作用及机制[J].安徽医药,2001,5(1):55-57.
[29]张文青,张月明.抗性淀粉对糖尿病大鼠胰岛素抵抗的影响[J].营养学报,2008,30(3):257-261.
[30]Liese AD,Schulz M,Fang F,et al.Dietary glycemic index and glycemic load,carbohydrate and fiber intake,and measures of insulin sensitivity,secretion and adiposity in the Insulin Resistance Atherosclerosis Study[J].Diabetes Care,2005,28(12):2832-2838.