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目的探讨个体化和量化营养干预对2型糖尿病患者代谢及饮食结构的影响。方法采用随机抽样法,按入选条件选取上海市曹杨社区卫生服务中心55~75岁在册管理的106例2型糖尿病患者为调查对象,其中有94例完成研究,失访12例,失访率为11.3%,以居委会为基础分为对照组45例,干预组49例。干预组进行为期3月的个体化和量化营养干预和教育指导,制定个体化营养治疗方案,能量按照统一原则供给。教育手段包括一对一教育、分阶段集体教育及资料发放等。干预开始前后分别对受检者进行膳食调查、体格检查及实验室相关指标检测。结果经个体化和量化营养干预后,干预组体质指数[(23.65±3.23)kg/m2]较对照组[(25.19±2.68)kg/m2]有所下降,差异有统计学意义(P<0.05);空腹血糖[(6.39±2.89)mmol/L]、餐后2 h血糖[(9.89±6.42)mmol/L]、糖化血红蛋白[7.0(5.9~9.0)mmol/L]均较对照组[分别为(7.09±3.43)、(11.34±4.62)、7.2(6.5~9.0)mmol/L]明显下降,差异均有统计学意义(P<0.05);干预组健康饮食评分(health eating index,HEI)[(65.96±5.89)分]较对照组[(61.31±3.49)分]显著上升,差异有统计学意义(P<0.05)。结论在社区糖尿病管理工作中,个体化和定量化营养干预可有效控制患者的血糖水平,改善患者膳食结构。
Objective To explore the effects of individualized and quantitative nutritional intervention on the metabolism and dietary structure of type 2 diabetic patients. Methods A total of 106 patients with type 2 diabetes mellitus were enrolled in Shanghai Caoyang Community Health Service Center under the age of 55 to 75 years. 94 patients completed the study and 12 patients were lost to follow-up. The rate of loss to follow-up was 11.3% were divided into control group (45 cases) and intervention group (49 cases) based on neighborhood committee. Intervention group for a period of March of individualized and quantitative nutrition intervention and education guidance, develop individualized nutrition treatment program, energy supply in accordance with the principle of unity. Educational means include one-on-one education, phased collective education and information dissemination. Before and after the intervention, subjects were subjected to dietary surveys, physical examinations and laboratory related indicators. Results Compared with the control group [(25.19 ± 2.68) kg / m2], the body mass index of the intervention group [(23.65 ± 3.23) kg / m2] decreased after individualized and quantified nutritional intervention, the difference was statistically significant (6.39 ± 2.89) mmol / L], postprandial blood glucose (9.89 ± 6.42 mmol / L), and HbA1c (7.0-9.9 mmol / L) in the control group [ (7.09 ± 3.43), (11.34 ± 4.62) and 7.2 (6.5-9.0 mmol / L), respectively. The difference was statistically significant (P <0.05). The health eating index (HEI) [(65.96 ± 5.89) points] compared with the control group [(61.31 ± 3.49) points] significantly increased, the difference was statistically significant (P <0.05). Conclusion In community diabetes management, personalized and quantitative nutrition intervention can effectively control the patient’s blood glucose levels and improve the patient’s diet.