2型糖尿病拉丁裔患者中血糖指数降低与血糖控制改善相关。
Decrease in Glycemic Index Associated with Improved Glycemic Control among Latinos with Type 2 Diabetes.
作者信息
Wang Monica L, Gellar Lauren, Nathanson Brian H, Pbert Lori, Ma Yunsheng, Ockene Ira, Rosal Milagros C
出版信息
J Acad Nutr Diet. 2015 Jun;115(6):898-906. doi: 10.1016/j.jand.2014.10.012. Epub 2014 Dec 26.
BACKGROUND
Glycemic index and glycemic load are used to facilitate glucose control among adults with type 2 diabetes, with a low glycemic index diet associated with improved glycemic control.
OBJECTIVE
To examine long-term longitudinal associations between changes in glycemic index and glycemic load with glycemic and metabolic control among Latino adults with diabetes.
DESIGN
Secondary data from intervention and comparison participants in the Latinos en Control trial (2006 to 2008) were analyzed.
PARTICIPANTS/SETTING: Data on dietary intake and metabolic characteristics were from low-income, Latino adults (N=238; 87.7% Puerto Rican) with type 2 diabetes.
INTERVENTION
The Latinos en Control trial was a randomized clinical trial targeting diabetes self-management among Latinos with type 2 diabetes. Participants were randomized to a group-based behavioral intervention or usual care and followed through 12 months.
MAIN OUTCOME MEASURES
Outcomes included hemoglobin A1c (HbA1c) levels, fasting blood glucose, lipid profiles, anthropometrics, and blood pressure.
STATISTICAL ANALYSIS
Glycemic index and load were analyzed using data from three 24-hour dietary recalls conducted at baseline, 4 months, and 12 months. Repeated measures regression models were used to examine change in glycemic index and load associated with metabolic characteristics at 12 months. Covariates included sex, age, body mass index, blood pressure, total energy intake, medication use and intensity, physical activity, intervention status (intervention vs usual care), and time.
RESULTS
Increases in glycemic index from baseline to 12 months were associated with increased logarithm of HbA1c levels (β=0.003; P=0.034) and waist circumference (β=0.12; P=0.026) over time, but not with fasting glucose, blood lipids, or body mass index. There was modest evidence to support small, positive associations between glycemic load and HbA1c levels and waist circumference.
CONCLUSIONS
Lowering glycemic index is associated with improvements in certain metabolic risk factors among Latinos with diabetes. Targeting glycemic index may be an important component of dietary strategies for diabetes self-management.
背景
血糖生成指数和血糖负荷用于帮助2型糖尿病成人控制血糖，低升糖指数饮食与改善血糖控制相关。
目的
研究糖尿病拉丁裔成年人血糖生成指数和血糖负荷变化与血糖及代谢控制之间的长期纵向关联。
设计
对拉丁裔控制试验（2006年至2008年）中干预组和对照组参与者的二级数据进行分析。
参与者/研究背景：饮食摄入和代谢特征数据来自患有2型糖尿病的低收入拉丁裔成年人（N = 238；87.7%为波多黎各人）。
干预措施
拉丁裔控制试验是一项针对2型糖尿病拉丁裔患者糖尿病自我管理的随机临床试验。参与者被随机分为基于小组的行为干预组或常规治疗组，并随访12个月。
主要观察指标
观察指标包括糖化血红蛋白（HbA1c）水平、空腹血糖、血脂谱、人体测量指标和血压。
统计分析
使用基线、4个月和12个月时进行的三次24小时饮食回顾数据来分析血糖生成指数和负荷。重复测量回归模型用于检验12个月时血糖生成指数和负荷变化与代谢特征的关联。协变量包括性别、年龄、体重指数、血压、总能量摄入、药物使用及强度、身体活动、干预状态（干预组与常规治疗组）和时间。
结果
从基线到12个月血糖生成指数的增加与糖化血红蛋白水平对数增加（β = 0.003；P = 0.034）和腰围增加（β = 0.12；P = 0.026）相关，但与空腹血糖、血脂或体重指数无关。有适度证据支持血糖负荷与糖化血红蛋白水平和腰围之间存在小的正相关。
结论
降低血糖生成指数与改善糖尿病拉丁裔患者的某些代谢危险因素相关。针对血糖生成指数可能是糖尿病自我管理饮食策略的重要组成部分。
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