低血糖负荷膳食营养教育对社区糖调节受损患者血糖和胰岛素的影响
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- 英文论文题名：Effect of low glycemic load diet management on the glucose and insulin in community patients with impaired glucose regulation
- 论文作者：陈超刚 ; 何凤怡 ; 刘和菊 ; 黎峰 ; 戚以勤 ; 林刁珠 ; 林秀红 ; 严励
- 英文论文作者：CHEN Chao-gang ; HE Feng-yi ; Liu He-ju ; Li Feng ; QI YI-qin ; LIN Diao-zhu ; Lin Xiu-hong ; YAN Li
- 年：2016
- 作者机构：中山大学孙逸仙纪念医院;
- 论文关键词：营养教育 ; 糖调节受损 ; 血糖负荷 ; 血糖 ; 胰岛素
- 英文论文关键词：impaired glucose regulation ; glycemic load ; glucose ; insulin ; diet management
- 会议召开时间：2016-11-29
- 会议录名称：广州市第十届健康教育学术交流会文集
- 语种：中文
- 分类号：R587.1
- 学会代码：SJKS
- 会议名称：广州市第十届健康教育学术交流会
- 会议地点：中国广东广州
- 主办单位：广州市健康教育所、广州市预防医学会健康教育专业委员会
- 学会名称：广州市健康教育所
- 页数：6
- 文件大小：401k
- 原文格式：O
- 会议级别：地方
摘要
目的:在社区对糖调节受损(IGR)患者进行营养教育和膳食干预,观察低血糖负荷膳食管理模式(LGLM)对降低血糖和改善胰岛素抵抗的作用。方法:在广州城区某社区选取40-64岁IGR患者,分为LGLM组和对照组。LGLM组接受并坚持LGLM干预,包括基于血糖负荷(GL)的营养教育、使用低GL食谱(GL/Mcal.d低于常规食谱10%)和应用GL管理软件,共12个月。对照组接受平衡膳食营养教育,并使用常规食谱。结果:纳入研究对象共265名,其中,LGLM组133例,对照组132例。基于GL的营养教育可显著提高GL认知水平和低GL膳食行为。干预前后比较,LGLM组FBG无显著性差异,对照组干预后显著增高(P<0.0001)。干预后,LGLM组PBG和HbA1c较干预前分别降低16.7%±21.8%和7.4%±8.6%,降低程度均高于对照组,以上变化均有显著性差异(P<0.0001)。与干预前比较,干预后LGLM组胰岛功能指数(HOMA-β)增高46.3%±125.7%(P=0.0011);胰岛素抵抗指数(HOMA-IR)比干预前增高,增高程度低于对照组(P<0.001);胰岛素敏感指数(ISI)降低,降低程度低于对照组(P<0.001)。结论:采取基于GL的营养教育和低GL膳食管理,可有效提高社区IGR患者GL知识水平和维持低GL膳食状况,并可有效降低患者餐后血糖和糖化血红蛋白,减缓胰岛素抵抗发展。
Objective:To observe the effects of dietary management model based on low glycemic load(LGLM) on glucose metabolism and insulin in community residents with impaired glucose regulation(IGR).?Method:Patients aged 40-64 with IGR from community epidemiological investigation were randomly divided into LGLM group and control group.LGLM group was accepted education based on glycemic load(GL) and dietary management based on GL management software application and was required to reach the standard that dietary GL was10%or above lower the standard meal.Control group was accepted traditional education of balanced diet.Results:265 subjects finished the study,of whom 133 were LGLM group and 132 were control group.After nutritional education and dietary management,knowledge and attitude of GL and LGL control rates of patients were reach the standard and have low GL diet during 12 months.Compared with before investigation,after LGLM diet management,FBG of LGLM group was no significant change but of control group was significant increased(P<0.0001).PBG and HbAlc of LGLM group were(16.7±21.8)%and(7.4±8.6)%decreased,P<0.0001 respectively and descend range of LGLM group was significant higher than that of control group(P<0.0001).HOMA-IR of LGLM group was(38.4±57.9)%increased and ascend range of LGLM group was significant lower than control group(P=0.0020).HOMA-βof LGLM group was(46.3±125.7)%increased and ascend range was no significant difference between both two groups.ISI of LGLM group was(15.8 ±34.7)%decreased and descend range of LGLM group was significant higher than control group(P=0.0002).Conclusion:Nutritional education and dietary management based on GL could improve knowledge and practical ability in patients with IGR.Compared with standard meal,reducing 10%or above dietary GL may help patients with IGR improve PBG and HbAlc,and Slow down the development of insulin resistance.
Objective:To observe the effects of dietary management model based on low glycemic load(LGLM) on glucose metabolism and insulin in community residents with impaired glucose regulation(IGR).?Method:Patients aged 40-64 with IGR from community epidemiological investigation were randomly divided into LGLM group and control group.LGLM group was accepted education based on glycemic load(GL) and dietary management based on GL management software application and was required to reach the standard that dietary GL was10%or above lower the standard meal.Control group was accepted traditional education of balanced diet.Results:265 subjects finished the study,of whom 133 were LGLM group and 132 were control group.After nutritional education and dietary management,knowledge and attitude of GL and LGL control rates of patients were reach the standard and have low GL diet during 12 months.Compared with before investigation,after LGLM diet management,FBG of LGLM group was no significant change but of control group was significant increased(P<0.0001).PBG and HbAlc of LGLM group were(16.7±21.8)%and(7.4±8.6)%decreased,P<0.0001 respectively and descend range of LGLM group was significant higher than that of control group(P<0.0001).HOMA-IR of LGLM group was(38.4±57.9)%increased and ascend range of LGLM group was significant lower than control group(P=0.0020).HOMA-βof LGLM group was(46.3±125.7)%increased and ascend range was no significant difference between both two groups.ISI of LGLM group was(15.8 ±34.7)%decreased and descend range of LGLM group was significant higher than control group(P=0.0002).Conclusion:Nutritional education and dietary management based on GL could improve knowledge and practical ability in patients with IGR.Compared with standard meal,reducing 10%or above dietary GL may help patients with IGR improve PBG and HbAlc,and Slow down the development of insulin resistance.
引文
[1]Xu,Y.,Wang,L.&He,J.,et al.Prevalence and Control of Diabetes in Chinese Adults[J].JAMA.?2013,310(9):948-959.
[2]Livesey,G1.,Taylor,R.,Livesey,H.,et al.Is There a Dose-response Relation of Dietary Glycemic Load to Risk of Type 2 Diabetes?Meta-analysis of Prospective Cohort Studies[J].Am J Clin Nutr,2013,97(3):584-596.
[3]Ziaee A,Afaghi A,Sarreshtehdari M.Effect of low glycemic load diet on glycated hemoglobin(HbAlc)in poorly-controlled diabetes patients[.Glob J Health Sci,2011,4:211-216.
[4]黄李春,张坚,王春荣,等.中国成人膳食生糖负荷现状调查.营养学报,2008,30(3):229-233.
[5]陈超刚,何凤怡,林刁珠,等.血糖负荷软件在中老年糖调节受损患者中的应用效果观察.老龄科学研究,2014,2(10):64-67,78.
[6]姜春花,蔡美琴,刘秀玲,等.血糖指数结合血糖负荷在糖尿病防治中的应用与效果评价[J].营养学报,2009,31:334-338.
[7]Brand-Miller JC,Holt SH,Pawlak DB,et al.Glycemic index and obesity[J].Am J Clin Nutr,2002,76:s281-s285.
[8]Ludwig DS.The glycemic index;physiological mechanisms relating to obesity,diabetes,and cardiovascular disease[J].JAMA,2002,287:2414-2423.
[9]Bhupathiraju SN,Tobias DK,Malik VS,et al.Glycemic index,glycemic load,and risk of type 2 diabetes:results from 3 large US cohorts and an updated meta-analysis.Am J Clin Nutr.2014;100(1):218-32.
[10]林秀红,陈超刚,林刁珠,等.新诊断2型糖尿病患者膳食血糖负荷与血糖、血脂的关系.中华内分泌代谢杂志.2014;30(7):562-564.[11]马文君,戚本华,张燕,等.不同营养治疗方法在妊娠期糖代谢异常中的应用中华预防医学杂志,2011,,45(5):426-429.
[12]陈超刚,苏宜香,严励,等.低血糖生成指数膳食对糖调节受损患者的影响.营养学报,2007,29:16-19.
[21]Ziaee A,Afaghi A,Sarreshtehdari M.Effect of low glycemic load diet on glycated hemoglobin(HbAlc)in poorly-controlled diabetes patients.Glob J Health Sci,2011,4:211-216.
[13]Afaghi A,Ziaee A,Afaghi M.Effect of low-glycemic load diet on changes in cardiovascular risk factors in poorly controlled diabetic patients.Indian J Endocrinol Metab,2012,16:991-995.
[14]Brand-Miller JC.Home of the glycaemic index,glycaemic load.Internet;http://www.glycemicindex.com.
[15]Ebbeling CB,Leidig MM,Feldman HA,et al.Effects of a low-glycemic load vs low-fat diet in obese young adults;a randomized trial.JAMA,2007,297:2092-2102.
[16]杨柳,谢虹,费小芸.2型糖尿病患者血糖负荷相关饮食知识影响因素的调查[J].皖南医学院学报,2013,32(2):157-160.
[17]李英华,李莉,聂雪琼,等.中国六省城乡居民糖尿病高危因素和风险意识调查.中华预防医学杂志,2014,48(7):555-560.
[18]曾庆奇,蒋莹,袁雁飞,等.糖尿病患者健康素养与健康管理的关系.中华预防医学杂志,2014,48(8):715-719.
[19]Darren C.Greenwood,Diane E.Threapleton,?Charlotte E.L.Evans,et al.Glycemic Index,Glycemic Load,Carbohydrates,and Type 2 Diabetes:Systematic review and dose-response meta-analysis of prospective studies.Diabetes Care.2013 Dec;36(12):4166-4171.
[2]Livesey,G1.,Taylor,R.,Livesey,H.,et al.Is There a Dose-response Relation of Dietary Glycemic Load to Risk of Type 2 Diabetes?Meta-analysis of Prospective Cohort Studies[J].Am J Clin Nutr,2013,97(3):584-596.
[3]Ziaee A,Afaghi A,Sarreshtehdari M.Effect of low glycemic load diet on glycated hemoglobin(HbAlc)in poorly-controlled diabetes patients[.Glob J Health Sci,2011,4:211-216.
[4]黄李春,张坚,王春荣,等.中国成人膳食生糖负荷现状调查.营养学报,2008,30(3):229-233.
[5]陈超刚,何凤怡,林刁珠,等.血糖负荷软件在中老年糖调节受损患者中的应用效果观察.老龄科学研究,2014,2(10):64-67,78.
[6]姜春花,蔡美琴,刘秀玲,等.血糖指数结合血糖负荷在糖尿病防治中的应用与效果评价[J].营养学报,2009,31:334-338.
[7]Brand-Miller JC,Holt SH,Pawlak DB,et al.Glycemic index and obesity[J].Am J Clin Nutr,2002,76:s281-s285.
[8]Ludwig DS.The glycemic index;physiological mechanisms relating to obesity,diabetes,and cardiovascular disease[J].JAMA,2002,287:2414-2423.
[9]Bhupathiraju SN,Tobias DK,Malik VS,et al.Glycemic index,glycemic load,and risk of type 2 diabetes:results from 3 large US cohorts and an updated meta-analysis.Am J Clin Nutr.2014;100(1):218-32.
[10]林秀红,陈超刚,林刁珠,等.新诊断2型糖尿病患者膳食血糖负荷与血糖、血脂的关系.中华内分泌代谢杂志.2014;30(7):562-564.[11]马文君,戚本华,张燕,等.不同营养治疗方法在妊娠期糖代谢异常中的应用中华预防医学杂志,2011,,45(5):426-429.
[12]陈超刚,苏宜香,严励,等.低血糖生成指数膳食对糖调节受损患者的影响.营养学报,2007,29:16-19.
[21]Ziaee A,Afaghi A,Sarreshtehdari M.Effect of low glycemic load diet on glycated hemoglobin(HbAlc)in poorly-controlled diabetes patients.Glob J Health Sci,2011,4:211-216.
[13]Afaghi A,Ziaee A,Afaghi M.Effect of low-glycemic load diet on changes in cardiovascular risk factors in poorly controlled diabetic patients.Indian J Endocrinol Metab,2012,16:991-995.
[14]Brand-Miller JC.Home of the glycaemic index,glycaemic load.Internet;http://www.glycemicindex.com.
[15]Ebbeling CB,Leidig MM,Feldman HA,et al.Effects of a low-glycemic load vs low-fat diet in obese young adults;a randomized trial.JAMA,2007,297:2092-2102.
[16]杨柳,谢虹,费小芸.2型糖尿病患者血糖负荷相关饮食知识影响因素的调查[J].皖南医学院学报,2013,32(2):157-160.
[17]李英华,李莉,聂雪琼,等.中国六省城乡居民糖尿病高危因素和风险意识调查.中华预防医学杂志,2014,48(7):555-560.
[18]曾庆奇,蒋莹,袁雁飞,等.糖尿病患者健康素养与健康管理的关系.中华预防医学杂志,2014,48(8):715-719.
[19]Darren C.Greenwood,Diane E.Threapleton,?Charlotte E.L.Evans,et al.Glycemic Index,Glycemic Load,Carbohydrates,and Type 2 Diabetes:Systematic review and dose-response meta-analysis of prospective studies.Diabetes Care.2013 Dec;36(12):4166-4171.