CAJ | 학술논문

目的：探讨不同医学营养治疗方法对老年2型糖尿病患者血糖波动性的影响。方法将85例2型糖尿病患者按完全随机分组法分为3组，对照组29例、低血糖生成指数（GI）膳食组27例、水溶性膳食纤维组29例，3组均参照中国糖尿病医学营养治疗指南给予糖尿病膳食指导，并给予口服降糖药，低 GI 膳食组早晚餐完全用低 GI 膳食替代，水溶性膳食纤维组在早、晚餐时各添加水溶性膳食纤维10 g 。干预期为1个月，干预前后观察各组患者血糖、血脂、肾功能及血糖波动情况。结果与干预前比较，各组干预后血糖均有不同程度下降（P ＜0．05），低 GI 膳食组及水溶性膳食纤维组干预后血糖波动性指标明显下降（P＜0．05）。与对照组比较，干预后低 GI 膳食组空腹血糖平均值、餐后血糖平均值、血糖平均值明显下降（P＜0．05），干预后低 GI 膳食组和水溶性膳食纤维组血糖标准差、平均血糖波动幅度明显低于对照组（P＜0．05）。结论老年2型糖尿病患者在糖尿病膳食指导及口服药物治疗基础上，给予低 GI 膳食替代治疗或添加水溶性膳食纤维，能有效控制血糖水平，明显降低血糖的波动性。
목적：탐토불동의학영양치료방법대노년2형당뇨병환자혈당파동성적영향。방법장85례2형당뇨병환자안완전수궤분조법분위3조，대조조29례、저혈당생성지수（GI）선식조27례、수용성선식섬유조29례，3조균삼조중국당뇨병의학영양치료지남급여당뇨병선식지도，병급여구복강당약，저 GI 선식조조만찬완전용저 GI 선식체대，수용성선식섬유조재조、만찬시각첨가수용성선식섬유10 g 。간예기위1개월，간예전후관찰각조환자혈당、혈지、신공능급혈당파동정황。결과여간예전비교，각조간예후혈당균유불동정도하강（P ＜0．05），저 GI 선식조급수용성선식섬유조간예후혈당파동성지표명현하강（P＜0．05）。여대조조비교，간예후저 GI 선식조공복혈당평균치、찬후혈당평균치、혈당평균치명현하강（P＜0．05），간예후저 GI 선식조화수용성선식섬유조혈당표준차、평균혈당파동폭도명현저우대조조（P＜0．05）。결론노년2형당뇨병환자재당뇨병선식지도급구복약물치료기출상，급여저 GI 선식체대치료혹첨가수용성선식섬유，능유효공제혈당수평，명현강저혈당적파동성。
Objective To investigate the effects of different medical nutrition therapy on blood glucose variability in elderly patients with type 2 diabetes .Methods Eighty‐five patients with type 2 diabetes were randomly divided into three groups ,29 cases in the control group ,27 cases in the low GI diet group ,29 cases in water‐soluble dietary fiber group .Each patient was established a individuality diabetic diet recipe according to the guidelines of medical nutrition therapy ,combined with oral hypoglycemic agents , The breakfast and dinner for patients in low GI diet group were completely instead of low GI diet ,while the breakfast and dinner for patients in water‐soluble dietary fiber group were added 10 g dietary fiber .Blood glucose ,blood lipid ,renal function and blood glu‐cose fluctuation were observed before and after one‐month intervention .Results Compared with before intervention ,the concentra‐tion of blood glucose after the intervention in each group were decreased (P < 0 .05) ,the glucose fluctuation index in low GI diet group and water soluble dietary fiber group decreased obviously after the intervention (P< 0 .05) .After the intervention ,average fasting blood glucose ,postprandial glucose average ,and mean blood glucose in low GI diet group were significantly lower than those in control group (P< 0 .05) ,Meanwhile ,the blood sugar standard deviation and MAGE in low GI dietary intervention group and in water‐soluble dietary fiber group were significantly lower than that of control group (P< 0 .05) .Conclusion On the basis of the di‐abetes diet recipes and oral drug treatment giving low GI dietary replacement therapy or adding water soluble dietary fiber ,for eld‐erly patients with type 2 diabetes ,could effectively control the blood glucose level ,and significantly reduce glucose variability .