白血病合并糖尿病患者的饮食和血糖控制护理研究

目的 探究白血病合并糖尿病患者应用饮食和血糖控制护理模式的可行性。方法 选择2020年2月—2021年2月来泉州市第一医院就诊的80例白血病合并糖尿病患者作为研究对象,以随机数表法分为两组,每组40例。对照组实施常规护理模式,观察组实施饮食和血糖控制护理模式。对比两组患者血糖水平、营养状况以及希望水平。结果 观察组空腹血糖（FPG）、餐后1 h血糖（1 hPG）、餐后2 h血糖（2 hPG）、糖化血红蛋白（HbA1c）水平低于对照组,差异有统计学意义（P<0.05）。观察组白蛋白、前白蛋白、转铁蛋白营养状态水平高于对照组,差异有统计学意义（P<0.05）。观察组对现实与未来的态度、采取的积极行动、与他人保持的亲密关系评分高于对照组,差异有统计学意义（P<0.05）。结论 白血病合并糖尿病患者应用饮食和血糖控制护理模式,在改善患者血糖水平、调节营养状态以及强化希望水平等方面均具有显著的积极意义。     

治疗性饮食干预对糖尿病合并脑卒中患者血糖控制效果的影响

脑卒中是糖尿病并发症之一.本研究观察治疗性饮食干预对糖尿病合并脑卒中患者血糖控制效果的影响.     

糖尿病饮食治疗现状

糖尿病饮食治疗是糖尿病治疗的重要环节,也是不容易被全科医生和病人所准确掌握的部分。本文就糖尿病饮食治疗的原则,营养目标,营养成分比例及糖尿病饮食计算方法等方面进展作一综述。     

糖尿病患者的饮食治疗

饮食治疗是糖尿病治疗的基石，也是糖尿病教育的重要内容，糖尿病是否能够控制的关键就在于是否正确理解和执行饮食治疗的措施。饮食治疗并非单纯不吃糖，更不是饥饿疗法，最终要求是合理营养总量和各种合理营养物质的分配。     

饮食日记监测血糖

夏季,对于糖尿病患者来说,既要吃得有营养,保证足够能量,又要维持血糖稳定,这是需要注意的饮食原则。糖尿病患者要学会记     

饮食营养与糖尿病

治疗糖尿病的方法有哪些？糖尿病的治疗是一项长期而细致的工作,目前尚还没有找到单一治疗能获得完全满意效果的方法,故必须结合病人实际情况采取综合治疗措施。综合治疗措施包括：合理饮食、适当运动、药物治疗、病情监控、健康教育与心理治疗,通常所说的防治糖尿病的“套马车”就是指的这些治疗措施。     

控制饮食不能走极端

对于饮食的态度,糖尿病患者一般分两种类型：第一种是无知无畏型,完全不懂营养知识,不管理自己的一日三餐,也不害怕血糖升高。第二种是过于谨慎型,他们不断学习各种营养知识,态度非常认真,但做法十分极端（如每餐的米饭都用天平称量）。这两种走极端的行为均不利于糖尿病的控制。     

饮食控制,掌握好度

饮食控制掌握好度,顾名思义就是对于饮食的控制要防止"过"和"不及"。糖尿病患者大都会被医生告知在糖尿病治疗过程中是要有饮食控制来配合的,但有些患者却控制得"过"了,这也不吃那也忌讳造成营养不均衡致使病情得不到良好控制;另外一些患者对饮食控制则又"不及",将医嘱当做耳旁风,对于饮食毫不避讳,终将造成无法弥补的遗憾。     

走出血糖控制的两大饮食误区

能吃什么？怎么吃？是糖尿病患者患病后最常见的问题。＂每天总量要量化,营养搭配合理化,食物种类丰富化,烹调过程清淡化。＂北京大学第一医院营养部主任孙孟里教授在一次以＂烹饪美食快乐控糖＂为主题的2009联合国糖尿病日家庭烹饪品评会上归纳了糖尿病患者饮食控制的原则。     

营养健康教育干预,提高糖尿病人家庭饮食控制行为的研究

随机选择部分住院病人,进行填卡咨询与出院后的随访、指导,共65例,分成干预组和对照组.结果：干预组营养治疗遵医程度、疗效明显高于对照组,P＜0.05.结论：通过对糖尿病病人的健康教育,提高了病人自我保护意识和科学的营养知识,有助于建立营养师——家庭双重督导机制.     

Attitudes, knowledge and blood glucose control

The hypothesis that management-related diabetes knowledge and attitudes may be more directly related to diabetic control than general knowledge of or general attitude towards diabetes is examined. Sixty Type 1 diabetic patients were studied using an itemized knowledge questionnaire and an attitude scale measuring a general attitude to diabetes but containing a previously defined subgroup of items concerned with attitudes to management. A significant linear correlation was found between management-related knowledge (r = -0.39; p less than 0.01) and HbA1c. However, knowledge of insulin, diet, footcare, and glucose monitoring were not significantly correlated with HbA1c, poor control being associated with both very low and very high knowledge status. A significant linear correlation was found between management-related attitudes (but not general attitude) and HbA1c (r = -0.47; p less than 0.01). The multiple regression correlation between HbA1c and both management knowledge and attitudes was -0.51. Most (63%) of the association between knowledge and HbA1c was attributable to attitude. This study provides support for education strategies based upon achieving improved patient attitudes and motivation rather than comprehensive knowledge as the most effective way of improving patient diabetic control.     

非体外循环冠状动脉旁路移植术中血糖调控的应用

目的 探讨非糖尿病患者非体外循环冠状动脉旁路移植术围术期血糖调控的效果。方法 将70例行OPCAB的非糖尿病患者随机分为2组,每组35例。分别接受胰岛素输注(试验组)或生理盐水输注(对照组),观察麻醉诱导前、搭桥前、搭桥后、关胸后、术后ICU1h、ICU6h、ICU12h、血糖值。结果 1.试验组与对照组相比,术后呼吸机使用时间(13.78±6.42vs19.02±9.74)、术后住院时间(19.54±5.72vs22.48±6.45)均显著缩短,术后心律失常发生率显著降低。2.试验组与对照组相比较,血糖在麻醉诱导前无统计学差异,而搭桥前、搭桥后、关胸后、ICU1h、ICU6h、ICU12h的血糖显著降低。结论 非糖尿病患者行OPCAB围术期高血糖可能影响预后,输注胰岛素输注可以有效控制血糖、改善雨后。     

Benfluorex and blood glucose control in non insulin-dependent diabetic patients

Benfluorex has been reported to decrease blood glucose in different dismetabolic conditions, particularly in noninsulin-dependent diabetic (NIDD) patients, but the mechanism of this effect is poorly known. We evaluate fasting glucose production (3H-glucose infusion) and B-cell secretion (phi 1, phi 2 and glucose utilization SI) (minimal model technique) in 7 mild, diet treated, NIDDM patients after 6-week administration of benfluorex (450 mg/day) and placebo, in random sequence and double blind design. Body weight, HbA1c, plasma glucose profile, fasting plasma insulin, lactate, pyruvate, beta-OH-butyrate, total cholesterol, HDL-cholesterol and triglycerides were also measured at the end of each treatment. Mean values of body weight (71 +/- 4 vs 69 +/- 4 kg, p less than 0.01), HbA1c (8.3 +/- 0.2 vs 7.7 +/- 0.2%, p less than 0.01), fasting plasma glucose (137.0 +/- 6.5 vs 121.4 +/- 5.6 mg/dl, p less than 0.01), lactate (1.82 +/- 0.13 vs 1.22 +/- 0.11 mmol/l, p less than 0.0025) pyruvate (0.164 +/- 0.011 vs 0.095 +/- 0.010 mmol/l, p less than 0.0005), and beta-OH-butyrate (0.91 +/- 0.06 vs 0.66 +/- 0.04 mmol/l, p less than 0.005) were significantly lower after benfluorex than after placebo. phi 1, phi 2 and SI values were not significantly different in the two treatments. Fasting glucose production was significantly lower after benfluorex than after placebo: 2.46 +/- 1.57 vs 1.84 +/- 0.85 mg/kg.min, p less than 0.02. These results demonstrate that 6-week treatment with benfluorex produces a significant blood glucose lowering effect in mild NIDDM patients, mainly by decreasing glucose production.     

Rate control versus rhythm control

PURPOSE OF REVIEW: The results of five randomized clinical trials comparing rate control with rhythm control in the management of atrial fibrillation have been published recently. The purpose of this report is to review their main results and selected subanalyses and other related data to offer practical recommendations regarding the treatment of patients with this common arrhythmia. RECENT FINDINGS: In the aggregate, the five trials enrolled a total of 5175 subjects and accumulated 16,186 patient-years of follow-up. All these trials have had similar results in that each of them failed to demonstrate a clear advantage of the rhythm control approach over that of rate control. The largest of the studies, the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) study, enrolled 79% of all the cases in the five trials and accounts for 88% of the cumulative follow-up experience and for 92% of all deaths. Among AFFIRM participants, antiarrhythmic drug use did not improve survival, stroke risk, quality of life, or functional capacity but was associated with increased resource use. In several of the trials, however, the presence of sinus rhythm was associated with improved outcomes. SUMMARY: The evidence is now overwhelming that for most patients with atrial fibrillation, rhythm control using currently available antiarrhythmic drugs is more expensive but not more effective than the rate control strategy in the prevention of major adverse events. Further research is needed to determine whether maintaining sinus rhythm by other means can improve outcomes.     

Association between circadian rhythm of blood pressure and glucose tolerance status in normotensive,non-diabetic subjects

AimsTo examine whether circadian rhythm of blood pressure (BP) is associated with glucose tolerance status in normotensive, non-diabetic subjects.MethodsA cross-sectional study recruited normotensive and non-diabetic subjects, aged 35–79 years. A 75 g oral glucose tolerance test (OGTT) and 24-h ambulatory blood pressure monitoring (24-h ABPM) were performed.ResultsAmong 31 impaired glucose tolerance (IGT) and 36 normal glucose tolerance (NGT) study subjects, the mean (±S.D.) diurnal–nocturnal differences of average systolic BP (SBP) were 7.1 ± 6.9 and 9.9 ± 6.2 mm Hg, respectively (p = 0.086). In a linear mixed-effects regression model, however, taking each measurement of BP as the outcome, nighttime reduction of SBP in the IGT group was 7.19 mm Hg, which was significantly smaller compared to a reduction of 9.80 mm Hg in the NGT group (p-value for IGT: nighttime interaction = 0.0014). The prevalence of non-dipping BP pattern was 77.4% in the IGT group which was significantly higher than 52.8% of the NGT group (p = 0.036). Logistic regression revealed a significant effect of IGT for predicting non-dipping pattern with an adjusted odds ratio of 3.71 (95% CI: 1.09, 12.66, p = 0.029).ConclusionsAmong normotensive, non-diabetic subjects, the decreased nocturnal BP reduction was associated with impaired glucose tolerance status.     

Optimizing blood glucose control in type 2 diabetes: an approach based on fasting blood glucose measurements

A structured approach to the management of Type 2 diabetes, aiming to reduce fasting blood glucose levels to near-normal, can provide effective blood glucose control with minimal risk of hypoglycaemia and in a manner acceptable to most patients. When the fasting blood glucose value is maintained in the region 4-6 mmol l-1, protein glycosylation and plasma triglyceride values usually become near-normal and this may help to prevent the development of long-term diabetic complications. We propose a simple management strategy, based on 3-monthly fasting blood glucose determination, which uses not more than two therapeutic agents at any one time. If diet and maximal oral therapy fail to keep fasting blood glucose levels below 6 mmol l-1 then the addition of a basal insulin supplement, e.g. from a once daily injection of ultralente insulin, can restore near-normal fasting blood glucose levels without the need for full insulin replacement therapy. In older patients, where long-term prevention of diabetic complications is not such an immediate priority, less strict blood glucose control may be reasonable, aiming to keep the fasting blood glucose values below 10 mmol l-1 in order to prevent symptoms secondary to glycosuria. Patients can be seen at a monthly general practice morning diabetic mini-clinic or with the aid of a nurse visiting elderly patients at home.