碳水化合物交换份法饮食干预对2型糖尿病合并超重及肥胖患者疗效分析

目的 探讨标准化的碳水化合物交换法饮食干预在T2DM合并超重及肥胖患者中的作用。方法 选取2014年12月~2016年12月在笔者医院中美糖尿病中心收治的新发以及发现后未服用或仅口服降糖药的T2DM合并超重或肥胖的患者共140例，随机分为干预组和对照组。干预组实行碳水化合物交换份饮食干预（糖尿病饮食指导和住院期间糖尿病标准餐干预），对照组实行常规的饮食指导。每周随访1次，3个月后测定干预前后FPG、餐后2h血糖、HbA1c和TC、TG、LDL-C、HDL-C等生化指标以及体重及BMI等人体测量指标，并对比干预与否的临床结局差别。结果 碳水化合物交换法饮食干预后，患者的FPG、餐后2h血糖、HbA1c、TG及BMI较干预前有明显降低，差异有统计学意义（P<0.05）；与对照组相比，干预后能明显降低住院医疗费用并提高患者FPG达标率，差异有统计学意义（P<0.05）。结论 碳水化合物交换法饮食干预可明显改善T2DM合并超重或肥胖患者的血糖水平，有利于患者的血糖控制及治疗。

Effects of Food Exchange Portion of Carbohydrate on Patients of 2-diabetes Mellitus Combining with Overweight or Obesity

Objective To study the effect of food exchange portion of carbohydrate on patients with 2-diabetes mellitus combining with overweight or obesity.Methods Totally 140 patients of incipient 2-diabetes mellitus combining with overweight or obesity were selected from Diabetes center of China and the United States of Zhejiang hospital from December, 2014 to December, 2016, without treatment or only with hypoglycemic drugs. Two groups were divided randomly, one dietary intervention with food exchange portion of carbohydrate named teatment group, the other matched group only treatment with dietary instruction. Indexs of FPG, 2 hours postprandial blood glucose, HbA1c, blood lipid, body weight and BMI were compared before and after 3 months of intervention. Meanwile clinical results of intervention of food exchange portion of carbohydrate or not were also compired.Results After treatment of standarded food exchange portion of carbohydrate, indexs of FPG, 2 hour postprandial blood glucose, HbA1c, TG and BMI were reduced observably. Hospitalization expenses reduced and rate of FPG to normal highly improved compried with matched group. All differences were statistically significant(P<0.05).Conclusion Intervention of food exchange portion of carbohydrate can obviously improve the glucose levels, in favour of the conduction and treatment on patients of 2-diabetes mellitus combining with overweight or obesity.