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Received:December 17, 2019 Published Online:September 20, 2020
Received:December 17, 2019 Published Online:September 20, 2020
中文摘要: 目的 为探究不同减重模式对超重2型糖尿病患者血糖波动及心肺功能的影响。方法 选取住院应用胰岛素降糖治疗且血糖控制平稳的超重2型糖尿病患者120例,随机分成高脂低碳生酮饮食组(30例)、限能量均衡膳食组(30例)、普通糖尿病膳食组(30例)、普通糖尿病膳食+饭后30 min有氧运动组(30例),分别给予低碳生酮饮食、限能量均衡膳食、普通糖尿病膳食及普通糖尿病膳食+饭后30 min有氧运动干预,应用雅培瞬感血糖仪检测患者14 d内皮下组织葡萄糖浓度,以血糖变异系数(CV)、空腹血糖变异系数(CV-FPG)、最大血糖波动幅度(LAGE)、平均血糖波动幅度(MAGE)、餐后血糖波动幅度(PPGE)、日间血糖平均绝对差(MODD)、血糖水平标准差(SDBG)等指标评价各组患者血糖波动情况;继续维持相应干预措施3个月、6个月后复测心肺功能等指标。结果 低碳生酮饮食组患者的CV、CV-FPG、LAGE、MAGE、PPGE、MODD、SDBG均显著低于其他三组,差异有统计学意义(P<0.05);限能量均衡饮食组和普通糖尿病膳食+饭后30 min有氧运动组患者的以上各指标均显著低于普通糖尿病膳食组患者,差异有统计学意义(P<0.05),而限能量均衡饮食组和普通膳食+饭后30 min有氧运动组患者的以上各指标差异均无统计学意义(P>0.05)。干预3个月和干预6个月时,普通糖尿病膳食+饭后30 min有氧运动组患者的肺活量及第一秒用力呼气量均显著高于其他三组,差异有统计学意义(P<0.05),且其他三组之间差异无统计学意义(P>0.05)。结论 低碳生酮饮食是维持超重2型糖尿病患者血糖稳定的最优减重模式,普通糖尿病膳食+饭后30 min有氧运动可以有效改善患者心肺功能。
Abstract:Objective To investigate the impacts of different weight loss models on blood glucose fluctuations and cardiopulmonary function in overweight patients with type 2 diabetic mellitus (T2DM). Methods A total of 120 overweight patients with T2DM receiving insulin therapy and stable blood glucose level were selected and randomly divided into ketogenic diet composed of high fat and low carbonhydrate group(ketogenic diet group), calorie balanced diet group (balanced diet group), common diabetes diet group (common diet group) and common diabetes diet plus aerobic exercise for 30 minutes after meal group (aerobic exercise group) according to different diet pattern (n=30, each).The blood glucose variation coefficient (CV), CV of FPG concentrations (CV-FPG), maximum blood glucose fluctuation(LAGE), mean amplitude of glycemic excursions(MAGE), postprandial blood glucose fluctuation range (PPGE), mean absolute difference daytime blood glucose(MODD), standard deviation of mean level of blood glucose fluctuation (SDBG) and other indicators were detected to evaluate the blood glucose fluctuation in each group.Maintaining appropriate interventions for 3 months and 6 months, the indexes of cardiopulmonary function were measured again. Results The values of CV, CV-FPG, LAGE, MAGE, PPGE, MODD, SDBG in ketogenic diet group were significantly lower than those in other three groups (all P<0.05) and were significantly lower in balanced diet group and aerobic exercise group than those in common diet group(P<0.05), however, there were no obvious differences in them between balanced diet group and aerobic exercise group(all P>0.05).At 3 and 6 months after intervention, the vital capacity and the forced expiratory volume in the first second(FEV1) in aerobic exercise group were significantly higher than those in other three groups (all P<0.05), and there were no statistical differences in them among the three groups(P>0.05). Conclusion Low carbon ketogenic diet is the best method for weight loss in overweight type 2 diabetic patients, and ordinary diabetic diet plus 30-min aerobic exercise after meal can effectively improve the cardiopulmonary function of overweight patients with T2DM.
keywords: Type 2 diabetic mellitus Weight loss model Blood sugar fluctuation Cardiopulmonary function
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基金项目:石家庄市科学技术研究与发展计划(181460923)
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