低纤维肠内营养素对糖尿病患者肠道准备质量、血糖及舒适度的影响

目的 探讨在饮食限制不超过24 h的前提下,低纤维肠内营养素对糖尿病患者结肠镜镜检前肠道准备质量、血糖及舒适度的影响。方法 将住院行结肠镜检查的糖尿病患者108例随机分为对照组55例,观察组53例,镜检前一天晚餐对照组进食低纤维半流质,观察组进食低纤维肠内营养素,两组饮食热卡均由营养科根据患者身高、体重计算出,热卡一致,采用渥太华肠道准备评估量表评估两组肠道清洁度,比较肠道准备开始至镜检结束时两组血糖变化趋势、最大血糖波动幅度(largest amplitude of glycemic excursion, LAGE)、低血糖发生率和舒适度。结果 观察组肠道清洁度优于对照组(P<0.05);除镜检前一天17:00、镜检当天13:00外,其余时间点对照组血糖值均低于观察组(P<0.05);观察组低血糖发生率低于对照组(χ²=3.89,P<0.05),LAGE低于对照组(P<0.01);两组舒适度比较,观察组满意度高于对照组(P<0.05),排便次数及肛门疼痛感低于对照组(P<0.01)。结论 低纤维肠内营养素组肠道清洁度及舒适度优于低纤维半流质组,且低纤维肠内营养素有利于降低糖尿病患者肠道准备期间血糖波动幅度和低血糖发生率。

Low-fiber enteral nutrients in effect on intestinal cleanliness and blood glucose and comfort level in diabetes patients

Objective To investigate the effect of low-fiber enteral nutrients on intestinal cleanliness, blood glucose and comfort level of diabetic patients during bowel preparation of time-restricted feeding less than 24 hours. Methods Totally 108 diabetic inpatients underwent colonoscopy were randomly divided into two groups: the control group (n=55), the observation group (n=53). In the dinner on day-0 of microscopic examination, the control group was managed semi-fluid low-fiber food, and low-fiber enteral nutrients in the observation group. The calorie volume of the two groups was same, which calculated from the nutrition department according to the height and weight of these patients. The Ottawa Bowel Preparation scale (oBPs) was employed to assess effects of intestinal cleanliness, from the beginning to end of endoscopic examinationthe, the key observation was blood glucose value, largest amplitude of glycemic excursion (LAGE), the incidence of hypoglycemia and comfort level in the two groups.Results The better intestinal cleanliness was found in the observation group (P<0.05). Except for day-0 17:00 and day-1 13:00 of the microscopic examination, the control group had lower blood glucose values on other time points (P<0.05), and lower incidence of hypoglycemia was detected in the observation group (χ²=3.89, P<0.05), LAGE was lower in the observation group vs the control group (P<0.01); in the comfort level, the observation group indicated higher the satisfaction (P<0.05), with the reduction of defecation frequency and anal pain (P<0.01). Conclusion During bowel preparation, low-fiber enteral nutrients can improve intestinal cleanliness and comfort level, better than semi-liquid low-fiber food, which has merit to reduce blood glucose fluctuations and incidence of hypoglycemia for diabetic patients.