食物GI与交换份用于2型糖尿病营养治疗观察

目的观察将食物血糖生成指数（GI）与食物交换份法（FE）结合运用于2型糖尿病患者的营养治疗后血糖血脂的变化以及患者对营养治疗的依从性，以寻求更好的糖尿病营养治疗方法。方法选取符合2型糖尿病诊断且合并血脂异常的住院患者80例，随机平均分为A、B两组。在临床药物治疗方案一致的基础上，A组运用食物GI与食物交换份法结合的方法，B组单纯运用食物交换份法。对患者进行营养治疗和营养教育，出院后通过门诊复诊、电话随访，继续强化对患者的营养治疗，观察血糖血脂的变化以及患者对营养治疗的依从性。结果经住院营养治疗，出院前复查两组空腹血糖（FBG）、餐后2h血糖（2hPBG）均有显著下降（P〈0．01），组间无显著差异（P〉0．05）。三个月后复查，与刚入院时比较，两组患者FBG、2hPBG显著下降（P〈0．01），糖化血红蛋白（HbA1C）、血清胆固醇（TC）、血清三酰甘油（TG）与刚入院时比较均有显著下降（P〈0．05），血清高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—c）无显著变化（P〉0．05），组间无显著差异（P〉0．05）。对营养治疗依从性较好的A组35例（88．0％）、B组24例（60．0％），两组有显著差异（P〈0．01）。结论食物GI与交换份法能很好地控制2型糖尿病患者的血糖血脂情况，患者对食物GI与交换份法比对单纯食物交换份法的依从性高。

Observation of nutritional therapy using glycemic index and food exchange for type 2 diabetes mellitus

Objective Observe the effects of glycemic index(GI) and food exchange(FE) involved nutritional therapy on blood glucose and lipid levels in patients with type 2 diabetes mellitus(T2DM).Methods Eighty hospitalized patients with T2DM and abnormal blood lipids were divided into group A and group B.The nutritional therapy with GI and FE was used for patients in group A,and the nutritional therapy with only FE for group B.The nutritional therapy continued after patients discharged from the hospital.Blood glucose and lipid were examined after 3 months treatment.Results The fasting blood glucose(FBG) and 2hrs postprandial blood glucose(2hPBG) decreased significantly(P<0.01) in patients with hospitalized nutritional therapy.After 3 months treatment,FBG and 2hPBG decreased significantly(P<0.01).HbA1C,serum cholesterol and triglyceride also decreased significantly(P<0.05).However HDL-C and LDL-C did not change(P>0.05).The rates of compliance with this nutritional therapy were 88%(35 patients) in group A and 60%(24 patients) in group B respectively(P<0.01).Conclusion Blood glucose and lipids can be well controlled with GI and FE involved nutritional therapy in patients with T2DMl,and patients compliance with GI is higher than that with FE.