Jospe Michelle R, de Bruin Willemijn E, Haszard Jillian J, Mann Jim I, Brunton Mark, Taylor Rachael W
Department of Medicine, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Centre for Biostatistics, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
Appetite. 2020 Aug 1;151:104691. doi: 10.1016/j.appet.2020.104691. Epub 2020 Apr 1.
Hunger training teaches people to eat according to their appetite using pre-prandial glucose measurement. Previous hunger training interventions used fingerprick blood glucose, however continuous glucose monitoring (CGM) offers a painless and convenient form of glucose monitoring. The aim of this randomised feasibility trial was to compare hunger training using CGM with fingerprick glucose monitoring in terms of adherence to the protocol, acceptability, weight, body composition, HbA1c, psychosocial variables, and the relationship between adherence measures and weight loss.
40 adults with obesity were randomised to either fingerpricking or scanning with a CGM and followed identical interventions for 6 months, which included 1 month of only eating when glucose was under their individualised glucose cut-off. For months 2-6 participants relied on their sensations of hunger to guide their eating and filled in a booklet.
90% of the fingerpricking group and 85% of the scanning group completed the study. Those using the scanner measured their glucose an extra 1.9 times per day (95% CI 0.9, 2.8, p < 0.001) compared with those testing by fingerprick. Both groups lost similar amounts of weight over 6 months (on average 4 kg), were satisfied with the hunger training program and wanted to measure their glucose again within the next year. There were no differences between groups in terms of intervention acceptability, weight, body composition, HbA1c, eating behaviours, or psychological health. Frequency of glucose testing and booklet entry both predicted a clinically meaningful amount of weight loss.
Either method of measuring glucose is effective for learning to eat according to hunger using the hunger training program. As scanning with a CGM encouraged better adherence to the protocol without sacrificing outcome results, future interventions should consider using this new technology in hunger training programs.
饥饿训练教导人们通过餐前血糖测量，根据自身食欲进食。以往的饥饿训练干预措施使用指尖采血测血糖，然而持续葡萄糖监测（CGM）提供了一种无痛且便捷的血糖监测方式。这项随机可行性试验的目的是比较使用CGM的饥饿训练与指尖采血测血糖在方案依从性、可接受性、体重、身体成分、糖化血红蛋白（HbA1c）、心理社会变量以及依从性指标与体重减轻之间的关系。
40名肥胖成年人被随机分为指尖采血组或CGM扫描组，并接受相同干预6个月，其中包括1个月仅在血糖低于个体化血糖临界值时进食。在第2至6个月，参与者依靠饥饿感来指导进食，并填写一本手册。
指尖采血组90%和扫描组85%的参与者完成了研究。与指尖采血测试者相比，使用扫描设备的参与者每天额外测量血糖1.9次（95%置信区间0.9，2.8，p < 0.001）。两组在6个月内体重减轻量相似（平均4千克），对饥饿训练计划感到满意，并希望在未来一年内再次测量血糖。两组在干预可接受性、体重、身体成分、HbA1c、饮食行为或心理健康方面没有差异。血糖测试频率和手册填写情况均预测了具有临床意义的体重减轻量。
使用饥饿训练计划，两种测量血糖的方法对于学会根据饥饿感进食均有效。由于CGM扫描鼓励更好地遵守方案且不影响结果，未来的干预措施应考虑在饥饿训练计划中使用这项新技术。
