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正念饮食干预与糖尿病自我管理干预对 2 型糖尿病成人的比较效果:一项试点研究。

Comparative effectiveness of a mindful eating intervention to a diabetes self-management intervention among adults with type 2 diabetes: a pilot study.

机构信息

Department of Human Nutrition, The Ohio State University, Columbus, OH 43210, USA.

出版信息

J Acad Nutr Diet. 2012 Nov;112(11):1835-42. doi: 10.1016/j.jand.2012.07.036.

Abstract

Mindful eating offers promise as an effective approach for weight management and glycemic control in people with diabetes. Diabetes self-management education (DSME) is an essential component of effective self-care. Yet, little research has compared the effect of mindful eating to DSME-based treatment. This study compared the impact of these two interventions in adults with type 2 diabetes mellitus. A prospective randomized controlled trial with two parallel interventions was used. Participants included adults age 35 to 65 years with type 2 diabetes mellitus for 1 year or more, body mass index (BMI) of 27 or more, and hemoglobin A1c (HbA1c) of 7% or more who were randomly assigned to a 3-month mindful eating (MB-EAT-D; n=27) or Smart Choices (SC) DSME-based (n=25) intervention. Follow-up occurred 3 months after intervention completion. Dietary intake, physical activity, weight, HbA1c and fasting plasma glucose, and fasting insulin were assessed using repeated measures analysis of variance with contrast analysis. There was no significant difference between groups in the change in weight or glycemia at study end. Significant difference occurred between groups in the change in dietary intake/1,000 kcal of trans fats, total fiber, and sugars (all P<0.05). Mean (± standard error) reduction in weight (-2.92 ± 0.54 kg for SC vs -1.53 ± 0.54 kg for MB-EAT-D) and HbA1c (-0.67 ± 0.24% for SC and -0.83 ± 0.24% for MB-EAT-D) were significant (P<0.01). Significant reduction in energy intake and glycemic load occurred (all P<0.0001) for both groups. Training in mindful eating and diabetes self-management facilitate improvement in dietary intake, modest weight loss, and glycemic control. The availability of effective treatments gives patients with diabetes choices in meeting their self-care needs.

摘要

正念饮食作为一种有效的糖尿病患者体重管理和血糖控制方法具有广阔的前景。糖尿病自我管理教育(DSME)是有效自我护理的重要组成部分。然而,很少有研究比较过正念饮食与基于 DSME 的治疗方法的效果。本研究比较了这两种干预措施对 2 型糖尿病成人患者的影响。采用了前瞻性随机对照试验和两种平行干预措施。参与者包括年龄在 35 至 65 岁之间、患有 2 型糖尿病 1 年以上、体重指数(BMI)为 27 或以上、糖化血红蛋白(HbA1c)为 7%或以上的成年人,他们被随机分配到为期 3 个月的正念饮食(MB-EAT-D;n=27)或基于 Smart Choices(SC)的 DSME 干预组(n=25)。在干预完成后 3 个月进行随访。使用重复测量方差分析和对比分析评估膳食摄入、体力活动、体重、HbA1c 和空腹血糖以及空腹胰岛素。在研究结束时,两组在体重或血糖变化方面没有显著差异。两组在饮食摄入/每 1000 千卡反式脂肪、总纤维和糖的变化方面存在显著差异(均 P<0.05)。SC 组体重减轻(-2.92±0.54kg)和 HbA1c 降低(-0.67±0.24%)的平均值(±标准误差)显著(P<0.01),而 MB-EAT-D 组体重减轻(-1.53±0.54kg)和 HbA1c 降低(-0.83±0.24%)的平均值也显著(P<0.01)。两组的能量摄入和血糖负荷均显著降低(均 P<0.0001)。正念饮食和糖尿病自我管理的培训有助于改善饮食摄入、适度减轻体重和血糖控制。有效的治疗方法为糖尿病患者满足自我护理需求提供了选择。

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