营养治疗对代谢综合征标准的2型糖尿病患者的效果研究

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HbA1c、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。

Effects of Nutrition Therapy in the Population with Type2 Diabetes and Meeting Metabolic Syndrome Criteria

Objective To study the effects of medical nutrition therapy on dietary pattern change, metabolic control, cardiovascular disease risk prevention and life qualities improvement in the population with Type 2 diabetes and meeting metabolic syndrome criteria, which could provide the evidence for the disease management. Methods Patients of Type 2 diabetes who meeting metabolic syndrome criteria were selected. They were assigned to one of two groups: diet group (accepted medical nutrition therapy with good tolerance and compliance during the last 3-month) and control group (not accepted medical nutrition therapy). Basic information were collected. Food frequency questionnaire was used to investigate the dietary intake during the last 3-month. Clinical indicators of the disease control including glycosylated hemoglobin, blood glucose, blood lipids and waist circumference were collected. At the same time the diabetes-specific quality of life scale was used to investigate life qualities. Results Compared with control group, diet group was provided with relatively low-energy, high carbohydrate, low-fat, and high-fiber (P<0.05). Diet group showed reductions in glycosylated hemoglobin, postprandial glucose, total cholesterol and low density lipoprotein cholesterol (P<0.05 vs control group). Dietary therapy was associated with higher life qualities (specially in the mental/spiritual dimension) (P<0.05 vs control group). Conclusion Medical nutrition therapy during at least 3-month provides better benefits to type 2 diabetes patients meeting metabolic syndrome criteria for pattern change, metabolic control, cardiovascular disease risk prevention and life qualities improvement.