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目的探讨医学营养治疗对符合代谢综合征标准的2型糖尿病患者饮食结构改变、病情控制、心血管并发症预防及生活质量改善等方面的作用,为其疾病管理提供依据。方法选取既往(至少3个月前)符合代谢综合征标准的2型糖尿病患者,依据是否已接受糖尿病医学营养治疗(近3个月内耐受性及依从性良好)分别纳入治疗组及对照组。收集基本资料,采用半定量食物频率法调查近3个月内的膳食摄入情况。采集糖化血红蛋白Hb A1c、血糖、血脂、腰围等反映病情及其控制情况的临床指标,同时采用糖尿病生存质量特异性量表评估其生存质量。结果与对照组相比,治疗组平均能量摄入及脂肪供能比有所降低,糖类供能比及膳食纤维的平均摄入量有所增加(P<0.05)。治疗组患者的糖化血红蛋白、餐后2h血糖、总胆固醇及低密度脂蛋白胆固醇水平均显著低于对照组(P<0.05);治疗组患者生存质量总分及心理维度评分较对照组有显著改善(P<0.05)。结论医学营养治疗对于符合代谢综合征标准的糖尿病患者的病情控制及其心血管并发症预防方面有一定效果,同时,其生存质量(尤其是心理维度)亦有所提高。
Objective To investigate the effects of medical nutrition therapy on the changes of dietary structure, disease control, prevention of cardiovascular complications and improvement of quality of life in patients with type 2 diabetes who meet the criteria of metabolic syndrome and provide basis for disease management. Methods Patients with type 2 diabetes mellitus (up to 3 months before) meeting the metabolic syndrome criteria were enrolled in the treatment group and the control group, respectively, according to whether they had received medical treatment of diabetes mellitus (good tolerability and compliance within the past 3 months) . Collect basic information, the use of semi-quantitative food frequency survey of dietary intake within the past 3 months. Blood glucose, blood lipids, waist circumference and other clinical indicators reflecting the disease and its control were collected, and the quality of life of the patients was evaluated by the scale of life quality of diabetes mellitus. Results Compared with the control group, the average energy intake and the ratio of fat to energy in the treatment group were decreased, and the carbohydrate energy supply ratio and the average dietary fiber intake were increased (P <0.05). The glycosylated hemoglobin, 2h postprandial blood glucose, total cholesterol and low density lipoprotein cholesterol in the treatment group were significantly lower than those in the control group (P <0.05). The scores of quality of life and psychological dimension in the treatment group were significantly improved than those in the control group (P <0.05). Conclusions Medical nutrition therapy has some effect on disease control and prevention of cardiovascular complications in diabetic patients meeting the criteria of metabolic syndrome. At the same time, quality of life (especially psychological dimension) is also improved.