Rosenfalck A M, Almdal T, Viggers L, Madsbad S, Hilsted J
Department of Endocrinology, Hvidovre University Hospital, Copenhagen, Denmark.
Diabet Med. 2006 Apr;23(4):384-92. doi: 10.1111/j.1464-5491.2005.01810.x.
To compare the effects on insulin sensitivity, body composition and glycaemic control of the recommended standard weight-maintaining diabetes diet and an isocaloric low-fat diabetes diet during two, 3-month periods in patients with Type 1 diabetes.
Thirteen Type 1 patients were included, of whom 10 completed the cross-over study. Ten non-diabetic, matched control subjects were also examined. Body composition was estimated by dual-energy X-ray absorptiometry (DXA) whole-body scanning, diet intake was monitored by 7-day dietary record and insulin sensitivity was measured by the insulin clamp technique at baseline and after each of the diet intervention periods.
On an isocaloric low-fat diet, Type 1 diabetic patients significantly reduced the proportion of fat in the total daily energy intake by 12.1% (or -3.6% of total energy) as compared with a conventional diabetes diet (P = 0.039). The daily protein and carbohydrate intake increased (+4.4% of total energy intake, P = 0.0049 and +2.5%, P = 0.34, respectively), while alcohol intake decreased (-3.2% of total energy intake, P = 0.02). There was a significant improvement in insulin sensitivity on the isocaloric, low-fat diet compared with the standard diabetes diet [7.06 +/- 2.16 mg/kg/min (mean +/- sd) vs. 5.52 +/- 2.35 mg/kg/min (P = 0.03)]. However, insulin sensitivity remained 33% lower than in the control subjects (P = 0.021). No significant changes occurred in body weight or body composition. Glycated haemoglobin rose during both diet intervention periods (P = 0.18), with no difference between the two diets.
Change to an isocaloric, low-fat diet in Type 1 diabetic patients during a 3-month period resulted in significant improvement in insulin sensitivity without improvement in glycaemic control. However, insulin sensitivity remained 33% lower than in control subjects.
比较推荐的标准体重维持糖尿病饮食和等热量低脂糖尿病饮食在1型糖尿病患者两个3个月期间对胰岛素敏感性、身体成分和血糖控制的影响。
纳入13例1型患者，其中10例完成了交叉研究。还检查了10名匹配的非糖尿病对照受试者。通过双能X线吸收法（DXA）全身扫描估计身体成分，通过7天饮食记录监测饮食摄入量，并在基线和每个饮食干预期后通过胰岛素钳夹技术测量胰岛素敏感性。
与传统糖尿病饮食相比，1型糖尿病患者采用等热量低脂饮食时，每日总能量摄入中脂肪的比例显著降低了12.1%（或总能量的-3.6%）（P = 0.039）。每日蛋白质和碳水化合物摄入量增加（分别占总能量摄入的+4.4%，P = 0.0049和+2.5%，P = 0.34），而酒精摄入量减少（占总能量摄入的-3.2%，P = 0.02）。与标准糖尿病饮食相比，等热量低脂饮食的胰岛素敏感性有显著改善[7.06±2.16mg/kg/min（平均值±标准差）对5.52±2.35mg/kg/min（P = 0.03）]。然而，胰岛素敏感性仍比对照受试者低33%（P = 0.021）。体重或身体成分无显著变化。糖化血红蛋白在两个饮食干预期均升高（P = 0.18），两种饮食之间无差异。
1型糖尿病患者在3个月期间改为等热量低脂饮食可使胰岛素敏感性显著改善，但血糖控制无改善。然而，胰岛素敏感性仍比对照受试者低33%。
