食物交换份法联合食物血糖生成指数指导2型糖尿病病人饮食治疗的临床观察

目的采用自身对照观察初发2型糖尿病病人单纯给予食物交换份法进行饮食治疗及其联合食物血糖生成指数（GI）进行饮食治疗前后病人血糖及胰岛素抵抗指数等指标的变化，评价两种饮食治疗方法的疗效。方法选择初发2型糖尿病病人18例，首先接受单纯食物交换份法治疗3个月，之后接受食物交换份法联合GI治疗3个月，比较饮食治疗前后及两种方法治疗后病人体重指数（BMI）、空腹血糖（FPG）和空腹胰岛素（FINs）、糖化血红蛋白（HbA1c）及胰岛素抵抗指数（HOMA-IR）的变化。结果单纯食物交换份法治疗3个月后，病人BMI、FPG、HbA1c、FINS及HOMA-IR较饮食治疗前均明显降低（P〈0．001或P〈0.01）。联合GI治疗3个月后，病人BMI、FPG、HbA1c及HOMA-IR较联合GI治疗前明显降低（P〈0.001或P〈0.01）；FINS有下降趋势，但无统计学意义（P〉0.05）。结论饮食治疗能够改善初发2型糖尿病病人的血糖及胰岛素敏感性，食物交换份法是一种有效的治疗方法，食物交换份法联合GI进行饮食治疗优于单纯食物交换份法。

Nutritional Management Directed by Food Exchange Portion and Qlycemic Index for Patients with Type 2 Diabetes

Objective To study the effect of food exchange portion and glycemic index (GI) on plasma glucose and insulin resistance index in patients (pts) with early type 2 diabetes. Methods Eighteen pts with type 2 diabetes (T2DM) were diagnosed in recent months and received nutritional management directed by food exchange portion alone for 3 months. In another 3 months the pts were treated by food exchange portion combined with GI. The data of BMI, FPG, FINS, HbAlc,HOMA-IR were recorded. Results There were significantly decrease of BMI, FPG, FINS, HbAlc and HOMA-IR following 3 months of nutritional management directed by food exchange portion only (P<0.001 or P<0.01). The BMI, FPG, HbAlc and HOMA-IR were decreased further when the pts treated by food exchange portion combined with GI (P<0.001 or P<0.01), but there was no statistical difference in FINS (P>0.05). Conclusion Nutritional management could reduce blood glucose and improve insulin sensitivity greatly. Food exchange portion was effective for T2DM.