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[目的]以控制总能量和血糖负荷为主要手段,探讨营养治疗在糖尿病合并高脂血症患者中的作用。[方法]选取71名糖尿病合并高脂血症的患者,随机分为两组,在控制总能量和食物交换份的前提下,除主食外,两组选择的其他食物相同。对照组的36人只进行简单的健康教育,自由选择主食;低血糖负荷组35人,用血糖指数和血糖负荷指导选择主食,实验为期16周。实验前后测身高、体重、腰围(WC)、臀围(HC),计算体质指数(BMI)、腰臀比(WHR),测量三头肌皮褶厚度(TSF)、收缩压(SBP),检测空腹血糖(FBG)、甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)和糖化血红蛋白(HbAc)等各项指标。[结果]低血糖负荷组经饮食干预后,BMI、WC、WHR、TSF、SBP比干预前及对照组均有明显下降,除HDL-C外,血中TG、TC、FBG、HbAc均比对照组明显降低(P﹤0.05)。[结论]基于血糖负荷的营养治疗有助于合理选择食物,有效改善患者血糖、血脂和体脂水平。
[Objective] To control the total energy and blood glucose load as the main means to explore the nutritional therapy in patients with diabetes mellitus and hyperlipidemia. [Method] Totally 71 patients with diabetes mellitus and hyperlipidemia were randomly divided into two groups. Under the premise of controlling the total energy and food exchange, except for the staple food, the other foods selected by the two groups were the same. The control group of 36 people only simple health education, free to choose the staple food; low-glycemic load group of 35 people, with glycemic index and glycemic load guidance to choose the staple food, the experiment period of 16 weeks. Body height, weight, waist circumference (WC), hip circumference (HC), body mass index (BMI), WHR, TSF and SBP were measured before and after the experiment. Fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), high density lipoprotein (HDL-C) and glycosylated hemoglobin (HbAc) and other indicators. [Results] The levels of BMI, WC, WHR, TSF and SBP in the low-glycemic load group decreased significantly compared with those before intervention and in the control group after dietary intervention. The levels of TG, TC, FBG and HbAc were all lower than those in the control group Group was significantly lower (P <0.05). [Conclusion] Nutritional therapy based on blood glucose load can help to select food rationally and improve blood glucose, blood lipid and body fat level effectively.