超重与肥胖2型糖尿病患者的膳食能量摄入调查分析

  目的  调查和分析超重与肥胖2型糖尿病(T2DM)患者的膳食能量摄入情况。  方法  选取2018年2月—2020年2月在浙江省人民医院天台分院内分泌科就诊的T2DM患者128例为研究对象，根据BMI将患者分为体重正常组(45例)、超重组(48例)和肥胖组(35例)。选取同期在我院门诊就诊的健康非糖尿病体检者(健康体检组)45例作为对照组。比较和分析各组日均摄入总能量、膳食纤维摄入量，比较各组三大营养素的摄入量和供能及供能比。  结果  肥胖组患者日均总能量摄入明显高于体重正常组和超重组患者(均P < 0.01)。肥胖组患者碳水化合物摄入量明显高于体重正常组和超重组患者(均P < 0.01)。肥胖组患者碳水化合物供能明显高于体重正常组和超重组患者(均P < 0.01)；3组患者脂肪供能、蛋白质供能比较差异无统计学意义(均P>0.05)。3组患者的碳水化合物、脂肪和蛋白质供能比之间比较差异均无统计学意义(均P>0.05)，均高于指南推荐量。3组患者膳食纤维摄入量比较差异无统计学意义(P>0.05)，均低于指南推荐量。  结论  T2DM患者的膳食能量摄入不合理，肥胖T2DM患者的日均总能量摄入过量，能量过量的食物来源主要为碳水化合物，临床应对肥胖T2DM患者限制总能量和碳水化合物的摄入，降低脂肪供能比，并适当增加膳食纤维的摄入量。 

Analysis of dietary energy intake in overweight and obese patients with type 2 diabetes mellitus

  Objective  To investigate and analyse the dietary energy intake of overweight and obese patients with type 2 diabetes (T2DM).  Methods  A total of 128 T2DM patients admitted at our hospital from February 2018 to February 2020 were selected as the research object. They were divided into the normal weight group (45 cases), overweight group (35 cases) and obesity group (48 cases). A total of 45 healthy non-diabetic patients (healthy physical examination group) who visited our outpatient department during the same period were selected as controls. The daily total energy intake and dietary fibre intake of the three groups were compared and analysed, and the intake, energy supply and energy ratio of the three nutrients in each group were compared.  Results  The average daily total energy intake of the obesity group was significantly higher than that of the normal weight group and the hyperrecombination group (all P < 0.01). The carbohydrate intake in the obesity group was significantly higher than that in the normal weight group and the hyperrecombination group (all P < 0.01). The carbohydrate energy supply in the obesity group was significantly higher than that in the normal weight group and the hyperrecombination group (all P < 0.01). No statistical significance was observed in the comparison of fat and protein energy supply amongst the three groups (all P>0.05). The carbohydrate, fat and protein energy ratio results of the three groups were not statistically significant (all P>0.05) and were all higher than the recommended amount in the guidelines. No statistically significant difference was observed in dietary fibre intake amongst the three groups (P>0.05), which was lower than the recommended amount in the guidelines.  Conclusion  The dietary energy intake and daily total energy intake of obese T2DM patients are high, and the food source of excess energy is mainly carbohydrate. Clinical treatment for obese T2DM patients should involve limiting the intake of total energy and carbohydrate, reducing the fat energy supply ratio and appropriately increasing the intake of dietary fibre.