食物血糖生成指数在糖尿病营养教育中的应用研究

目的 :　通过营养教育 ,观察糖尿病患者对食物血糖生成指数 (glycemic index,GI)知、信、行的变化 ,以及改变膳食 GI对血糖、血脂的影响。方法 :　选择了 72例糖尿病病例作为研究对象 ,随机分为 2组。试验组以食物 GI为主要教育材料 (GI组 ) ;对照组以食物交换份 (food ex-change list,FEL)为主要教育材料 (FEL组 )。采用课堂讲座、个别辅导、电话咨询等方式教育 5个月。观察教育前后研究对象对所授知识的知晓率、膳食行为、血糖和血脂变化等。结果 :　经过连续教育 5个月后 ,GI组对 GI问题知晓率由 0 %提高到 92 .2 %(P<0 .0 1 ) ,FEL组对 FEL问题的知晓率由 6 .5 %提高到 79.4%(P<0 .0 1 ) ;GI组空腹血糖 (FBG)、餐后 2 h血糖 (2 h PBG)、糖化血红蛋白 (Hb A1c)、总胆固醇 (TC)、血脂综合指数 (LCI)均有显著性下降 (P<0 .0 1 ) ,FEL组仅 FBG、2 h PBG有显著性下降 (P<0 .0 1 )。结论 :　糖尿病营养教育是控制血糖、血脂的有效手段 ;GI知识较易被患者理解和掌握 ,通过 GI知识教育达到控制血糖和血脂的效果较为理想 ,便于在医院门诊和社区教育中广泛推广和应用。

THE RESEARCH ON APPLICATION IN THE EDUCATION WITH GLYCEMIC INDEX IN DIABETIC PATIENTS

Objective: To examine the effects of the education with glycemic index(GI)on dietary knowledge,attitude and practice of diabetic patients,and on their blood glucose and lipid.Methods: Seventy-two subjects with type 2 diabetes were randomly assingned into two groups. The test group (group GI) mainly learned the knowledge about GI of food. The controlled group (group FEL) mainly learned the knowledge about food exchange list(FEL). Outcomes were assessed by the change of dietary knowledge, attitude and practice, fasting blood glucose (FBG), 2 h postprandial blood glucose ( 2 hPBG), glycosylated hemoglobin (HbA 1c), and blood lipids which include total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and lipid comprehensive index (LCI). The period lasted five months. Results: The percent of correct answer for GI questions was increased significantly from 0 % before education to 92.2% after education (P<0.01) in group GI. The percent of correct answer for FEL questions was increased from 6.5% to 79.4% (P<0.01) in group FEL. The quality and quantity of food for almost subjects become more rational than before. The subjects of the group GI often selected more low-GI cereal, fruit,bean and its products, which are beneficial to glycemic control. FBG, 2 hPBG, HbA 1c, TC and LCI in the group GI were significantly decreased by (15.1±21.2)%, (16.2±24.4)%,(12.63±14.86)%, (5.85±11.93)% and (15.22±40.62)% respectively compared with those before education. Only FBG and 2 hPBG in the group FEL were significantly decreased by (10.6±21.4)% and (15.1±30.1)% respectively compared with those before education. Conclusion: The knowledge of food GI seems to be more easily understood and accepted by diabetic subjects, and more beneficial to improve dietary practice, blood glucose and lipid.