Masuda Kiyomi, Aoki Kazutaka, Kawaguchi Junko, Yamakawa Tadashi, Matsuba Ikuro, Terauchi Yasuo
Department of Endocrinology and Metabolism Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan.
J Clin Med Res. 2013 Oct;5(5):368-75. doi: 10.4021/jocmr1488w. Epub 2013 Aug 5.
The recommended total dietary energy intake prescribed medical nutrition therapy for obese or overweight patients with type 2 diabetes in Japan is often set at 25 kcal/kg ideal body weight (IBW)/day. This study was conducted to determine the impact of the total dietary energy intake (25 or 30 kcal/kg IBW/day) on the glycemic control, lipid profile, and satisfaction level in overweight patients with type 2 diabetes.
We performed interview and a designed prospective, randomized, controlled, multicenter study trial. Recruitment for interview for doctors and hospitalization of the obese or overweight patients with type 2 diabetes began from September 2008 and continued until June 2010. The subjects were randomly assigned to 25 kcal/kg IBW/day group (25 kcal group) or 30 kcal/kg IBW/day group (30 kcal group). The primary endpoint was the body weight of the subjects at the time of hospitalization, at the time of discharge from the hospital, and at 3, 6 and 12 months after discharge from the hospital.
The glycemic control, lipid control and body weight were similar between the 25 and 30 kcal groups during the 12-month follow-up, and the degree of satisfaction in respect of the medical treatment was significantly higher in the 30 kcal group than in the 25 kcal group at 1 year after discharge.
It is considered to be preferable for the caloric intake to be set at 30kcal/kg IBW/day rather than at 25 kcal/kg IBW/day for obese or overweight patients with type 2 diabetes.
在日本,针对肥胖或超重的2型糖尿病患者,医学营养治疗推荐的每日膳食总能量摄入通常设定为25千卡/千克理想体重(IBW)。本研究旨在确定每日膳食总能量摄入(25或30千卡/千克IBW)对超重2型糖尿病患者血糖控制、血脂水平及满意度的影响。
我们进行了访谈,并开展了一项设计好的前瞻性、随机、对照、多中心研究试验。2008年9月开始招募医生进行访谈以及肥胖或超重的2型糖尿病患者住院治疗,持续至2010年6月。将受试者随机分为25千卡/千克IBW/天组(25千卡组)或30千卡/千克IBW/天组(30千卡组)。主要终点是受试者住院时、出院时以及出院后3、6和12个月时的体重。
在12个月的随访期间,25千卡组和30千卡组的血糖控制、血脂控制及体重相似,出院1年后,30千卡组对治疗的满意度显著高于25千卡组。
对于肥胖或超重的2型糖尿病患者,热量摄入设定为30千卡/千克IBW/天比25千卡/千克IBW/天更为合适。