通过持续葡萄糖监测评估的宏量营养素麻比2饮食治疗反应性低血糖：MAHYP随机交叉试验。
Treatment of reactive hypoglycemia with the macrobiotic Ma-pi 2 diet as assessed by continuous glucose monitoring: The MAHYP randomized crossover trial.
作者信息
Soare Andreea, Khazrai Yeganeh Manon, Fontana Lucia, Del Toro Rossella, Lazzaro Maria Concetta, Di Rosa Claudia, Buldo Antonia, Fioriti Elvira, Maddaloni Ernesto, Angeletti Silvia, Di Mauro Antonio, Gesuita Rosaria, Skrami Edlira, Tuccinardi Dario, Fallucca Sara, Pianesi Mario, Pozzilli Paolo
机构信息
Unit of Endocrinology and Diabetes, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
Unit of Dietology and Diabetology, Sandro Pertini Hospital, Rome, Italy.
出版信息
Metabolism. 2017 Apr;69:148-156. doi: 10.1016/j.metabol.2017.01.023. Epub 2017 Jan 19.
BACKGROUND AND AIMS
Nutritional therapy is recommended for management of reactive hypoglycemia (RH), a condition characterized by hypoglycemia that occurs within four hours after a meal. The macrobiotic Ma-Pi 2 diet improves glycemic control in subjects with type 2 diabetes. We explored the effect of this diet on outcomes in non-diabetic individuals with RH.
MATERIALS AND METHODS
Twelve subjects with RH were randomized to the Ma-Pi 2 diet for three days and a control diet for three days in a randomized crossover design. Subjects received snacks on two days out of each three-day period only, and were monitored using continuous glucose monitoring. The 24-h period was divided into daytime (08:00-22:30h [subdivided into 'daytime without snacks' and 'daytime with snacks']) and night-time (22:31-07:59h). The effects of the two diets on the number of RH events (blood glucose <70mg/dL [3.9mmol/L]) and the percentage distribution of glucose readings within each of 16 glycemic intervals from <40mg/dL (2.2mmol/L) to >180mg/dL (4.4mmol/L) were determined.
RESULTS
There were significantly fewer RH events on the Ma-Pi 2 diet than the control diet during daytime without snacks (-2.5 events; 95% CI: -7.5, 0.0; P=0.022) and daytime with snacks (-4.25 events; 95% CI: -7.5; -2.0; P=0.013) but no difference at night. The percentage of glucose readings in the interval 71-80mg/dL (3.9-4.4mmol/L) was significantly higher on the control diet during daytime with and without snacks (P=0.03 for both), while the percentage of glucose readings in the interval 91-100mg/dL (5.1-5.6mmol/L) was significantly higher on the Ma-Pi 2 diet during daytime without snacks (P=0.02).
CONCLUSIONS
The macrobiotic Ma-Pi 2 diet reduced blood glucose excursions during the day, thereby facilitating glycemic control in subjects with RH. The Ma-Pi 2 diet represents an effective nutritional tool for management of RH.
背景与目的
营养疗法被推荐用于反应性低血糖（RH）的管理，这是一种以餐后四小时内发生低血糖为特征的病症。长寿饮食法中的麻比2饮食可改善2型糖尿病患者的血糖控制。我们探讨了这种饮食对非糖尿病RH患者结局的影响。
材料与方法
12名RH患者采用随机交叉设计，随机接受麻比2饮食三天，然后接受对照饮食三天。在每个为期三天的时间段中，仅在其中两天提供零食，并使用连续血糖监测进行监测。24小时时间段分为白天（08:00 - 22:30h[再细分为“无零食白天”和“有零食白天”]）和夜间（22:31 - 07:59h）。确定两种饮食对RH事件数量（血糖<70mg/dL[3.9mmol/L]）以及从<40mg/dL（2.2mmol/L）到>180mg/dL（4.4mmol/L）的16个血糖区间内血糖读数的百分比分布的影响。
结果
在无零食白天（-2.5次事件；95%置信区间：-7.5，0.0；P = 0.022）和有零食白天（-4.25次事件；95%置信区间：-7.5；-2.0；P = 0.013），麻比2饮食的RH事件明显少于对照饮食，但夜间无差异。在有零食和无零食白天，对照饮食中71 - 80mg/dL（3.9 - 4.4mmol/L）区间的血糖读数百分比均显著更高（两者P均 = 0.03），而在无零食白天，麻比2饮食中91 - 100mg/dL（5.1 - 5.6mmol/L）区间的血糖读数百分比显著更高（P = 0.02）。
结论
长寿饮食法中的麻比2饮食可减少白天的血糖波动，从而有助于RH患者的血糖控制。麻比2饮食是管理RH的一种有效营养工具。
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