体重干预对2型糖尿病合并肥胖患者近期生存质量的影响

目的探讨体重干预对于2型糖尿病合并肥胖患者近期生存质量的影响。方法将102例2型糖尿病合并肥胖患者随机分为体重干预组（n=53）及对照组（n=49）,体重干预组的干预措施包括健康教育、膳食指导和运动指导。比较两组患者入院时及6个月后的糖尿病生存质量特异性量表（diabetic quality of life,DSQL）评分,以及血糖（PG）、总胆固醇（TC）、三酰甘油（TG）、BMI、腰臀比、皮褶厚度等指标的变化。结果体重干预组患者的生理功能、社会关系维度及治疗维度与干预前及对照组干预后比较,均有统计学意义（P〈0.05或P〈0.01）;体重干预组患者的TG、TC、空腹PG及餐后2hPG与干预前及对照组干预后比较,均有统计学意义（P〈0.01）;两组患者的BMI、腰臀比及皮褶厚度的变化均无统计学意义。结论应对2型糖尿病合并肥胖患者加强体重干预,干预目标不应仅局限于体重的减轻,更应重视提高患者的自我管理水平,改善其生存质量。

Effect of Body Weight Intervention on the Short-term Quality of Life of Obese Type 2 Diabetic Patients

Objective To study the changes in the short-term quality of life of obese type 2 diabetic patients after body weight intervention.Methods A total of 115 patients were randomized into the weight intervention group(n=53) and the matched control group(n=49).The main body weight intervention measures included health education,dietary advising,and exercise advising.The quality of life of the patients was evaluated using the diabetic quality of life scale,and the blood glucose,total cholesterol(TC),triglycerides(TG),body mass index(BMI),waist-to-hip ratio,and the skinfold thickness were measured upon admission and at 6 months during the intervention.Results In the intervention group,the patients showed significantly improved physiological functions,social relations and therapeutic dimensions as compared with those before intervention and those in the control group(P<0.05 or 0.01).The intervention also resulted in significant changes in TG,TC,fasting blood glucose and 2 h postprandial glucose(P<0.01),but not in the BMI,waist-to-hip ratio or skinfold thickness.Conclusion Body weight intervention should be stressed in obese type 2 diabetic patients targeting at not only the body weight but also the self management of the patients to improve their quality of life.