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目的了解2型糖尿病患者的膳食状况及其与血糖控制的相关性。方法对广州某医院的2型糖尿病患者进行3 d 24 h膳食回顾调查、体格测量和血糖检测,并进行膳食状况与血糖控制情况的关联分析。结果共纳入223例2型糖尿病患者,以50~70岁(占54.7%)、男性(占57.0%)和超重(占47.5%)者为主,吸烟和饮酒率分别为23.8%(53/223)和6.7%(15/223)。轻、中、重体力活动者能量摄入量分别占推荐量的113.2%~149.1%、115.6%~122.9%和85.4%~97.4%。膳食纤维摄入量(8.3 g)和蛋白质供能比(14.0%)低于推荐量下限。维生素E和铁摄入量达到或超过推荐量(占104.4%~195.7%),维生素A、维生素B1、维生素B2、维生素C、钠和钙摄入量未达推荐量(占21.0%~87.8%)。蔬菜、水果、水产品、蛋类、奶类和大豆及坚果类摄入量未达推荐量,畜禽肉摄入量(100 g)超出推荐量上限。FPG、PPG和Hb A1c水平分别为(11.4±4.5)、(17.6±5.6)mmol/L和(9.3±2.1)%。血糖控制不良率为84.3%(188/223),与蛋白质供能比(r=0.165)、钙(r=0.223)和水产品(r=0.257)的摄入量呈正相关关系(P<0.05或P<0.01),且水产品摄入量<40 g/d和>75 g/d的患者血糖控制不良率均高于摄入40~75 g/d的患者,钙摄入≥90%RNI的患者血糖控制不良率低于摄入<90%RNI的患者(均P<0.01)。结论调查对象膳食不均衡,水产品、钙和蛋白质的摄入不合理可能与血糖控制不良有关,应加强营养教育和血糖监控,及时调整膳食方案。
Objective To understand the dietary status of patients with type 2 diabetes and its relationship with glycemic control. Methods The type 2 diabetes patients in a hospital in Guangzhou were investigated for 3 d 24 h diet, physical examination and blood glucose test, and the association between dietary status and glycemic control was analyzed. Results Totally 223 patients with type 2 diabetes were included. The prevalence was 50-70 years (54.7%), male (57.0%) and overweight (47.5%). The rates of smoking and drinking were 23.8% (53/223 ) And 6.7% (15/223). The light, medium and heavy physical activity energy intake accounted for the recommended amount of 113.2% ~ 149.1%, 115.6% ~ 122.9% and 85.4% ~ 97.4%. Dietary fiber intake (8.3 g) and protein to energy ratio (14.0%) were below the recommended limits. The intake of vitamin E and iron met or exceeded the recommended level (104.4% -195.7%) while the intake of vitamin A, vitamin B1, vitamin B2, vitamin C, sodium and calcium was less than the recommended level (21.0% -87.8% ). The intake of vegetables, fruits, aquatic products, eggs, milk and soybeans and nuts is less than the recommended amount, and the intake of poultry meat (100 g) exceeds the recommended upper limit. The levels of FPG, PPG and Hb A1c were (11.4 ± 4.5), (17.6 ± 5.6) mmol / L and (9.3 ± 2.1)%, respectively. The rate of poor blood glucose control was 84.3% (188/223) and positively correlated with the protein intake energy (r = 0.165), calcium (r = 0.223) and aquatic products (r = 0.257) P <0.01), and the incidences of malnutrition in patients with aquatic intakes <40 g / d and> 75 g / d were higher than those with 40 to 75 g / d The rate of poor glycemic control was lower in patients with <90% RNI (all P <0.01). Conclusions The surveyed diet is not balanced and the unreasonable intake of aquatic products, calcium and protein may be related to the poor control of blood glucose. Nutrition education and blood glucose monitoring should be strengthened and the diet plan adjusted in time.