两种膳食评价方法在2型糖尿病患者中的应用比较

目的 分析24 h膳食回顾法和中国膳食平衡指数（DBI）在2型糖尿病患者膳食调查及评价中的应用效果,了解2型糖尿病患者的膳食营养状况.方法 采用横断面调查研究的方法,抽取于2013年12月至2014年2月在上海市第六人民医院内分泌科新入院的18～59岁2型糖尿病患者,排除其中合并糖尿病肾病需要严格控制饮食蛋白质者,以及合并严重感染、甲状腺疾病等消耗性疾病,合并严重器质性疾病者.共入组100例,年龄（51.2±8.9）岁,男53例,女47例,应用24h膳食回顾法及DBI对其进行膳食调查及评价.结果 2型糖尿病患者微量营养素摄入普遍不足,维生素B1、B2、钙的摄入量均未达到每日膳食营养素参考摄入量（RNI）的50％.采用DBI进行评价,100例2型糖尿病患者饮食负端分为（32.1±6.1）分,65例（65％）存在中、高度的摄入不足.正端分为（4.4±2.8）分,无明显摄入过量问题.膳食质量距为36.4±6.9,普遍存在中度饮食失衡现象.87例（87％）膳食模式为模式B.结论 新入院2型糖尿病患者膳食结构不合理,应加强营养教育、进行营养干预.两种膳食调查方法都能独立进行评价膳食质量,若两者结合使用更利于评价.

Application of two dietary survey methods in type 2 diabetes patients

Objective To analyze and compare the differences in application of 24-hour dietary recall and dietary balance index （DBI） in dietary survey and evaluation of patients with type 2 diabetes mellitus,meanwhile investigate their nutrition status.Method This was a cross-sectional study.A total of 100 type 2 diabetes inpatients at the age of 19-59 were recruited from Shanghai Jiaotong University Affiliated Sixth People＇s Hospital from December 2013 to February 2014.They were surveyed and evaluated by 24-hour dietary recall and DBI respectively.Result The micronutrient intake in patients with type 2 diabetes was not sufficient.Compared with RNI,the intake of vitamin B1,B2,and calcium was less than 50%.The average of DBI lower bound score （DBI-LBS） of the 100 patients was 32.1±6.1,65%; the patients were in moderate or severe deficit of food intake.DBI higher bound score （DBI-HBS） was 4.4±2.8.No significant excess intake problem was found.Dietary quality distance was 36.4±6.9.Eighty-seven percent of them had a dietary patterns of mode B.Conclusion Dietary patterns in type 2 diabetes patients were not reasonable.Nutrition education and nutrition intervention for type 2 diabetes should be emphasized.The two methods can be used to evaluate dietary quality independently,but it would be better to evaluate the quality of the patients＇ diet using two dietary survey methods together.