胰岛素治疗后肥胖2型糖尿病患者1年期低能量饮食干预的效果
Effect of one-year term low energy diet on obese type 2 diabetic patients with insulin intervention

蔡新妤.胰岛素治疗后肥胖2型糖尿病患者1年期低能量饮食干预的效果[J].内科急危重症杂志,2019,25(4):303-305

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DOI：10.11768/nkjwzzzz20190412

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作者	单位	E-mail
蔡新妤	新疆医科大学第一附属医院	tzhtzswm@163.com

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中文摘要:

目的：分析胰岛素治疗后肥胖2型糖尿病患者1年期低能量饮食干预的效果。方法：回顾性分析236例体重指数(BMI)≥28kg/m2的2型糖尿病患者的临床资料，根据是否采取1年期低能量饮食,分为对照组115例，采取普通糖尿病饮食；观察组121例，采取低能量饮食。比较2组患者治疗前与治疗1年后的体重、血压(收缩压、舒张压)、空腹血糖、空腹胰岛素、糖化血红蛋白、血脂(低密度脂蛋白、高密度脂蛋白)、血尿酸、γ-谷氨酰转肽酶，并以体重变化值、体重变化百分率、用药情况(双胍类和磺脲类降糖药用量、停药率)作为观察指标。结果：治疗前，2组体重、血压、空腹血糖、空腹胰岛素、糖化血红蛋白、血脂、血尿酸、γ-谷氨酰转肽酶水平比较,差异无统计学意义(P＞0.05)；治疗后，观察组体重轻于对照组，收缩压、舒张压、空腹血糖、空腹胰岛素、糖化血红蛋白、低密度脂蛋白、血尿酸、γ-谷氨酰转肽酶水平均低于对照组，高密度脂蛋白水平高于对照组 (均P<0.05)；观察组体重变化值、体重变化百分率、停药率均大于对照组，双胍类和磺脲类降糖药用量均少于对照组 (P<0.05或P<0.01)。结论：胰岛素治疗后肥胖2型糖尿病患者采取低能量饮食干预1年，能有效减轻患者的体重，改善代谢综合征，且减少降糖药用量。

英文摘要:

Objective: To analyze the effect of one-year low energy diet on obese type 2 diabetes mellitus patients following insulin intervention. Methods: The clinical data of 236 patients with type 2 diabetes mellitus with body mass index (BMI) ≥28kg/m2 were analyzed retrospectively. According to whether the one-year low-energy diet was used, the patients were divided into control group given routine diabetic diet (n=115), and observation group given the one-year low-energy diet (n=121). The body weight, blood pressure (systolic and diastolic), fasting blood glucose (FBG), fasting insulin, glycosylated hemoglobin, lipids (low density lipoprotein, high density lipoprotein), serum uric acid and γ-glutamyl transpeptidase were compared between two groups before and one year after treatment, and changes in body weight, body weight percentage, drug use (biguanide and hypoglycemic agents, withdrawal rate) were used as observation indicators. Results: After treatment, there was no significant difference in body weight, blood pressure, FBG, fast insulin, glycosylated hemoglobin, blood lipids, serum uric acid and γ-glutamyl transpeptidase between two groups (P>0.05). After treatment, the body weight, blood pressure, FBG, fasting insulin, glycosylated hemoglobin, low density lipoprotein, serum uric acid and γ-glutamyl transpeptidase were significantly reduced, and high density lipoprotein was significantly increased in the observation group as compared with those in the control group (all P<0.05); The changes in body weight, body weight percentage and withdrawal rate were significantly higher, and the usage of biguanide and sulfonose was significantly less in the observation group than those in the control group (P<0.05 or P<0.01). Conclusion: One-year low energy diet is effective in treating obese patients with type 2 diabetes after insulin treatment, effectively reducing the weight of patients, improving metabolic syndrome and reducing the dosage of hypoglycemic drugs, and is worthy of clinical use.