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接受两种不同饮食疗法的1型糖尿病儿童及青少年的血糖控制和血脂情况

Glycemic control and lipid profile of children and adolescents undergoing two different dietetic treatments for type 1 diabetes mellitus.

作者信息

Dalsgaard Haline, Saunders Cláudia, Padilha Patrícia de C, Luescher Jorge Luiz, Szundy Berardo Renata, Accioly Elizabeth

机构信息

Nutricionist. Master (MSc) in Human Nutrition by the Institute of Nutrition Josué de Castro (INJC). Federal University of Rio de Janeiro (UFRJ)..

Nutricionist. Doctor (PhD) in Sciences by Osvaldo Cruz Foundation (FIOCRUZ). Professor at the Departament of Nutrition and Dietetics-INJC/UFRJ. Coordinator of the Research Group on Maternal and Child Health (GPSMI) at INJC/UFRJ..

出版信息

Nutr Hosp. 2014 Mar 1;29(3):547-52. doi: 10.3305/nh.2014.29.3.7116.

Abstract

OBJECTIVE

To compare the glycemic control and lipid profile of children and adolescents undergoing two different dietetic treatments for type 1 Diabetes Mellitus assisted at the Children and Adolescent's Diabetes Mellitus Health Center-UFRJ.

METHODS

A retrospective longitudinal study conducted between 2002 and 2006. We evaluated the same subjects in two different periods: after 1 year in TD and subsequently after 1 year in CCHO. The evolution of the nutritional status during the dietary treatments was evaluated using Body Mass Index (BMI) for age. The lipid panel was evaluated according to the 1st Guideline for Prevention of Atherosclerosis in Childhood and Adolescence, used in Brazil, and the glycemic control was evaluated by measuring glycated hemoglobin (HbA1c).

RESULTS

We evaluated 93 individuals, 38.7% children and 61.3% adolescents. The mean age at study entry was 11.1 (± 2.66) years and the mean disease duration was 6.1 (± 3.2) years. A significant difference in the percentage of adequacy of HbA1c (p = 0.000) and in the values of total plasma cholesterol (p = 0.043) was found after 1 year of CCHO diet, which did not happen during the observation time of TD. The evolution of anthropometric nutritional status showed no significant difference between the beginning and the end of both dietary treatments.

CONCLUSION

The results of this study suggest that a more flexible food orientation program can contribute to the improvement of blood glucose levels without causing deterioration of the lipid profile when compared to TD.

摘要

目的

比较在里约热内卢联邦大学儿童与青少年糖尿病健康中心接受两种不同饮食治疗的1型糖尿病儿童和青少年的血糖控制情况及血脂水平。

方法

一项于2002年至2006年进行的回顾性纵向研究。我们在两个不同时期对同一批受试者进行评估:在传统饮食(TD)治疗1年后,随后在持续皮下胰岛素输注(CCHO)治疗1年后。使用年龄别体重指数(BMI)评估饮食治疗期间营养状况的变化。根据巴西使用的《儿童和青少年动脉粥样硬化预防第一指南》评估血脂水平,并通过测量糖化血红蛋白(HbA1c)评估血糖控制情况。

结果

我们评估了93名个体,其中儿童占38.7%,青少年占61.3%。研究开始时的平均年龄为11.1(±2.66)岁,平均病程为6.1(±3.2)年。在CCHO饮食治疗1年后,HbA1c达标百分比(p = 0.000)和总血浆胆固醇值(p = 0.043)存在显著差异,而在TD观察期内未出现这种情况。两种饮食治疗开始和结束时人体测量营养状况的变化均无显著差异。

结论

本研究结果表明,与TD相比,更灵活的食物导向计划有助于改善血糖水平,且不会导致血脂水平恶化。

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