糖尿病的营养治疗

糖尿病的营养治疗杜寿玢营养治疗在所有糖尿病患者的治疗与管理上是必要的，无论是Ⅰ型或Ⅱ型的糖尿病病人，无论是注射胰岛素或口服降糖药，均须坚持营养疗法。部分轻型病例，单纯控制饮食即可奏效。饮食、运动、药物三者的科学结合，再加上患者掌握糖尿病知识，均是糖尿...     

糖尿病临床营养研究进展

营养治疗对所有糖尿病患都是必要的．无论是1型或是2型的糖尿病病人，无论是注射胰岛素或口服降糖药，均须坚持营养疗法。现将最新的研究动态简述如下。     

营养不足与糖尿病

现认为糖尿病与营养(在病原学和治疗学上)均密切相关,营养过剩在诊断糖尿病时首先被注意到。现代对糖尿病的认识很大程度上基于Joslin的描述,而他清楚地意识到糖尿病是肥胖引起的。继之许多流行病学     

妊娠期糖尿病营养及相关因素研究

目的通过调控营养等可变因素来预防或降低妊娠期糖尿病(GDM)的发生。方法采用医网现代医学研究中心提供的人体成分分析仪和"孕期饮食营养分析与指导系统"(YQY)肌肉、脂肪分布测定,膳食调查采用半定量频率调查法。结果体质量增加、体脂含量、身体活动水平和蛋、奶量与GDM在关。结论孕期的膳食构成与GDM的发生发展有关。妊娠期科学合理的饮食指导能够降低不均衡饮食诱发GDM的风险,进而从整体上降低GDM的发生率。     

儿童糖尿病患儿营养风险筛查和营养评估

目的对儿童糖尿病患儿进行营养评估和营养风险筛查。方法选取2010—2013年间在该院接受治疗的儿童糖尿病患儿40例,对这些患儿采用微型营养评估法(MNA)和生化检测来对儿童糖尿病患儿进行一个综合的营养评估。结果微型营养评估法(MNA)显示在儿童糖尿病患儿中营养不良患儿所占的比例为18.75%,具有营养不良危险的患儿所占的比例为63.75%,营养正常的患儿所占的比例为17.50%;而在生化检测中,营养正常的儿童糖尿病患儿与营养不良的儿童糖尿病患儿相比,其总淋巴细胞计数(TLC)都要明显高于营养不良组,差异有统计学意义(P<0.05)。结论利用微型营养评估法(MNA)测定儿童糖尿病患儿的营养状况,有助于及早发现这类患儿的营养风险并能较早提出改进方案,有利于患儿的临床治疗。     

妊娠期糖尿病的医学营养治疗

中国妊娠期糖尿病( gestational diabetes mellitus,GDM) 患病率在增加,而不断升高的血糖水平与母体并发症 及新生儿代谢性疾病成正相关。医学营养治疗(medical nutrition treatment,MNT) 是糖尿病预防、管理和自我管理教 育不可或缺的一部分。GDM 的MNT 需要为胎儿和母体健康提供充足的营养,同时在无酮症的情况下达到正常的 血糖水平,并提供充足的能量使妊娠期获得适当的体重增长,以最大限度地确保母体及胎儿的安全,并改善GDM 孕 妇的远期预后。     

妊娠期糖尿病营养干预的研究进展

近年来妊娠期糖尿病(gestational diabetes mellitus,GDM)患病率稳步上升,目前国内外权威指南都没有在营养干预措施上形成一个统一的标准化方案,如何给GDM患者进行个体化营养干预尚未完全解决。该文总结对GDM患者进行营养干预的研究进展,归纳了目前GDM营养干预的主要措施,旨在为GDM患者进行个体化营养干预提供科学依据。     

肺结核合并糖尿病营养治疗的临床研究

目的研究营养干预对肺结核合并糖尿病患者病情恢复及血糖的影响,为肺结核合并糖尿病的防治提供营养治疗指导。方法观察30例肺结核合并糖尿病患者主动配合营养治疗后（干预组）痰菌转阴天数和血糖水平,并与没有进行营养干预的30例肺结核合并糖尿病患者（对照组）进行对比分析。结果干预组痰菌转阴的天数为12d,明显短于对照组的18d;干预组血糖控制明显优于对照组,均P〈0．05。结论营养治疗可使肺结核合并糖尿病患者的痰菌转阴天数明显缩短,血糖控制更为理想。     

营养治疗对妊娠期糖尿病的治疗效果研究

目的分析探讨营养治疗对妊娠期糖尿病的治疗效果,分析其对妊娠结局的影响。方法选择该院收治的妊娠期糖尿病患者100例作为该次研究的对象,收治时间在2013年2月—2014年2月,使用信封抽取法将这100例患者平均分成实验组(n=50)和对照组(n=50),对照组给予常规妊娠治疗,实验组在常规妊娠治疗的基础上给予营养治疗,并对比两组患者的血糖控制情况和妊娠结局。结果实验组的空腹血糖为(5.27±0.74)mmol/L,对照组的空腹血糖为(6.63±0.92)mmol/L,差异具有统计学意义(P0.05);实验组的新生儿Apgar评分和新生儿出生体重均高于对照组(P0.05);实验组的巨大儿发生率、胎儿窘迫发生率、新生儿窒息率、剖宫产率、胎膜早破率及贫血率均低于对照组患者,差异具有统计学意义(P0.05)。结论营养治疗对妊娠期糖尿病患者的治疗效果显著,可以有效控制患者妊娠期间的血糖水平,减少不良妊娠结局发生情况,改善母婴的妊娠结局,故营养治疗可在妊娠期糖尿病患者中应用推广。     

Knowledge and behavior changes in clinician after training of partnership for Diabetes Control in Indonesia

Background and aimsOne of the main determinants of successful diabetes management is the quality of healthcare provider including general practitioner and internist which can be increased through medical training. This study aimed to describe the changes of clinician’s knowledge and behavior of comprehensive diabetes management training program around Indonesia.MethodWe conducted a three-day training program for general practitioners and internists for 3.5 years, 2013 to 2016. All clinicians invited as voluntary participant to send their patient data from medical record. Each participant was expected to submit a minimum of 25 type 2 diabetes (T2DM) set patient data before and 6 months after training program to analyze the impact of program in physician knowledge and behavior related to diabetes management.Result120 of 489 voluntary participants submitted completed baseline data with 4676 patient data. Meanwhile, only 32 participants that submitted completed data of 6 months before after training with 886 patient data. Most of parameters were improve before and after program. The greatest and lowest improvement were on A1c measurement (21%) and smoking assessment (2%).ConclusionIntensive seminar and training was not enough to empower diabetes management. This research might push the creation of clinical practice program that were tailored to each care facilities and integrated within routine care aimed at continual improvement of its healthcare worker.     

合并糖尿病危重症患者的营养支持护理探讨

目的 探究合并糖尿病危重症患者的营养支持护理的临床效果.方法 选取从2017年2月—2019年3月收治于该院的80例合并糖尿病危重症患者作为研究对象,对ICU心肺功能损害危重症合并糖尿病患者进行治疗,患者进入医院的第2天便给予患者提供充足营养支持,选择4个主要时间点,对患者血糖和营养情况进行观察和记录.结果 治疗后,持...     

Knowledge of diabetes in Asians and Europeans with and without diabetes: the Coventry Diabetes Study.

Knowledge about the nature, symptoms, complications, and treatment of diabetes was assessed among United Kingdom Europeans and Asians with and without diabetes during the Coventry Diabetes Study. An open questionnaire was validated for use among Asians and Europeans and a 'Knowledge Index' constructed. The questions were answered by 3814 (87%) of 4395 Asians and 3783 (69%) of 5508 Europeans. Among those with known diabetes, 216 (96%) of 223 Asians and 98 (94%) of 104 Europeans answered the questions. The nature of diabetes was unknown in 30% of Europeans and 44% of Asians with diabetes, and 42% and 67%, respectively, could not name a single complication. Most of those without diabetes were unable to name either a complication (Europeans 66%, Asians 89%) or a single symptom (66% and 83%, respectively). The Knowledge Index was highest in Europeans, increased with increasing educational achievement, and was lowest in non-diabetic subjects without a family history of diabetes. Even those with diabetes had a low Knowledge Index.     

Knowledge of ocular complications of diabetes in community-based people with type 2 diabetes: The Fremantle Diabetes Study II

AimsTo assess knowledge of diabetes-related eye disease in Australians with type 2 diabetes and its associations with diabetic retinopathy (DR), other ocular complications and vision-related quality of life.MethodsA random sample from the Fremantle Diabetes Study Phase II cohort (n = 360) was invited to participate. Knowledge was assessed using 10 multiple-choice questions covering how diabetes affects the eyes, frequency of ophthalmic screening, risk factors, prevention, available treatments, and prognosis. DR was assessed from fundus photographs. Multiple linear regression was used to identify independent associates of the knowledge score (KS).ResultsWe included 264 participants (mean ± SD age 72.1 ± 9.2 years, 56.8% male, median [IQR] diabetes duration 15.4 [11.1–22.3] years). The mean ± SD KS out of 10 was 5.3 ± 1.8. Most (67%) participants knew diabetes can affect the eye and lead to blindness. Only 13.6% knew that DR screening intervals depend on risk factors. Those with moderate non-proliferative DR (NPDR) or worse had a better knowledge score (B = 1.37,P = 0.008) after adjusting for age (B = ?0.03, P = 0.004) and education beyond primary school (B = 1.75, P < 0.001).ConclusionsOverall knowledge of diabetes-related ocular complications was suboptimal. Education targeting eye disease may benefit people with type 2 diabetes who are older, less well educated and/or who have no DR/mild NPDR.     

糖尿病并发抑郁症的研究进展

抑郁症是糖尿病最常见和最危险的并发症之一。糖尿病患者抑郁症的发生率明显高于一般人群,约有30%的糖尿病患者存在不同程度的抑郁症症状。两病并发将直接影响糖尿病患者的病情和生活质量。本文主要对糖尿病患者并发抑郁症的相关因素及其危害性加以探讨,为糖尿病患者防治抑郁症提供相关依据。     

Diabetes Education: Whose Priorities Are Met?

Two hundred Type 2 diabetic patients newly referred to the diabetes centre at a large university teaching hospital were studied over an 8-month period. Patients completed a diabetes knowledge questionnaire, and specified their educational priorities by selecting six diabetes-related topics from a list of 14. After giving 1 h of individual education and using the same list, the educators selected six topics which they considered to be most important for that particular patient to know. Choice of educational priorities differed between the patients and the corresponding educator (p less than 0.001). In only 38% of cases did the educators' first three priorities coincide with those of the patients. The major discrepancies were in the selection of 'sick day management' and 'complications', especially favoured by patients, as against 'oral hypoglycaemic agents' and other therapy-related topics, especially favoured by educators. Diabetes knowledge was a determinant of educational priority for patients (p less than 0.001) but not educators. In contrast, only the educators' overall choices were affected by duration of diabetes (p less than 0.001). Diabetes treatment type influenced both patients' and educators' selection of priorities (p less than 0.001). We conclude that an educational strategy which relies on health professionals' perceptions to determine what diabetic patients need to know may be inadequate.     

Knowledge profile and control in diabetic patients

Knowledge about diabetes was assessed using a previously described interactive computer-based questionnaire in 79 patients with insulin-dependent (IDDM) and 72 with non-insulin-dependent (NIDDM) diabetes mellitus routinely attending a single diabetic clinic. Simple linear correlation of total knowledge score with glycosylated haemoglobin (HbA1c) showed no significant relationship for either IDDM (r = 0.12: p = 0.18) or NIDDM (r = 0.15: p = 0.1). However, quintile grouping of knowledge scores showed the mean HbA1c to be significantly higher in the lowest scoring NIDDM quintile (10.6 +/- 0.5: +/- SE) with respect to the pooled mean of all the higher scoring quintiles (9.0 +/- 0.3) (p = 0.027). Mean HbA1c (9.6 +/- 0.5) was also higher in the least knowledgeable IDDM quintile than any other quintile group (range 8.8-9.0) but this was not significant with respect to the pooled mean of higher scoring patients (p greater than 0.1). The mean age of the lowest scoring IDDM quintile group (60.5 +/- 13.9 years) was significantly higher (p less than 0.01) than higher scoring IDDM groups (mean age range 36.5-43.3 years) but age was not significantly related to HbA1c in IDDM subjects. IDDM showed greater knowledge of diabetes than NIDDM but ignorance in key areas was unacceptably high in both diabetic subtypes, indicating that regular knowledge assessment and educational reinforcement may be essential for good diabetic control as well as patient safety, particularly in older IDDM patients.(ABSTRACT TRUNCATED AT 250 WORDS)     

Pancreatic Cancer and Diabetes Mellitus

In a series of 6,500 patients with diabetes mellitus there were 37 cases of primary carcinoma of the pancreas which significantly exceeded the expected number for the patient years at risk in both males and females (p<0.01). There was no evidence that pancreatic cancer was more common in patients with long-standing diabetes. The increased incidence of pancreatic cancer in diabetic patients is probably the result of patients presenting with the symptoms of diabetes as long as four years before the cancer becomes manifest. An underlying pancreatic tumour should be suspected when an elderly diabetic proves difficult to control and loses weight despite adequate treatment.