Liu Huaqing, Zhang Min, Wu Xuesen, Wang Chunhua, Li Zhong
Department of Preventive Medicine, Bengbu Medical College, Anhui, Bengbu, China.
Department of Health Management, Bengbu Medical College, Anhui, Bengbu, China.
Asia Pac J Clin Nutr. 2015;24(3):525-32. doi: 10.6133/apjcn.2015.24.3.07.
Diabetes mellitus requires lifelong treatment, most of which is accomplished in family and community settings. The present study was designed to identify the effectiveness of nutrition intervention provided by public dietitian on glycemic control in a community setting in China.
Two communities were selected and randomly assigned to a routine care group (59 subjects) and a public dietitian-led intervention group (58 subjects) who received diabetic nutrition management for one year. The main measures included fasting plasma glucose, HbA1c, weight, body mass index (BMI), lipid profile, and blood pressure.
In the intervention group, there was significant improvement in fasting plasma glucose, HbA1c, cholesterol, and triglyceride levels relative to the control subjects (p<0.05). Over the 12-month period, there was a decrease in energy intake, including reductions in absolute amounts (grams) of protein and fat in the intervention group. The energy percent values of carbohydrate, protein, and fat were 50.7%, 17.0%, and 32.3%, respectively, at baseline and 53.0%, 17.1%, and 29.9% (within the recommended range) after the intervention. There were significant improvements in total energy, absolute amounts of fat and protein, and the energy percent values of carbohydrates and fat. In the control group, however, these values were similar before and after the intervention, and the energy percent values of fat were still above the recommended range.
In a community setting, a diabetes nutrition intervention led by a public dietitian significantly improved the glycemic control of type 2 diabetic patients.
糖尿病需要终身治疗，其中大部分治疗是在家庭和社区环境中完成的。本研究旨在确定公共营养师提供的营养干预对中国社区环境中血糖控制的有效性。
选取两个社区，随机分为常规护理组（59名受试者）和公共营养师主导的干预组（58名受试者），干预组接受为期一年的糖尿病营养管理。主要测量指标包括空腹血糖、糖化血红蛋白、体重、体重指数（BMI）、血脂谱和血压。
与对照组相比，干预组的空腹血糖、糖化血红蛋白、胆固醇和甘油三酯水平有显著改善（p<0.05）。在12个月期间，干预组的能量摄入减少，包括蛋白质和脂肪绝对量（克）的减少。干预前碳水化合物、蛋白质和脂肪的能量百分比分别为50.7%、17.0%和32.3%，干预后分别为53.0%、17.1%和29.9%（在推荐范围内）。总能量、脂肪和蛋白质的绝对量以及碳水化合物和脂肪的能量百分比均有显著改善。然而，对照组干预前后这些值相似，脂肪的能量百分比仍高于推荐范围。
在社区环境中，由公共营养师主导的糖尿病营养干预显著改善了2型糖尿病患者的血糖控制。
