Otsu City Hospital, Otsu 520-0804, Japan.
Department of Food and Nutrition, Faculty of Home Economics, Kyoto Women's University, Kyoto 605-8501, Japan.
Nutrients. 2022 Jul 13;14(14):2865. doi: 10.3390/nu14142865.
The aim of this retrospective cohort study was to evaluate the effect of 5-year follow-up of dietitian-led medical nutrition therapy (eating vegetables before carbohydrates) on glycemic control in outpatients with type 2 diabetes (T2DM) at a primary care clinic. A total of 138 patients with dietitian-led medical nutrition therapy (intervention group) and 104 patients without dietitian-led nutrition therapy (control group) were compared for glycemic control, serum lipid, blood pressure, and diabetic complications for 5 years. Each patient in the intervention group received dietary education focused on food order (eating vegetables before carbohydrates) by dietitians. A significant improvement in HbA1c after 5 years in the intervention group [8.5 ± 1.7% (69 mmol/mol) to 7.6 ± 1.1% (59 mmol/mol), p < 0.001] was observed, whereas no change was observed in the control group [7.9 ± 1.2% (62 mmol/mol) to 8.0 ± 1.2% (63 mmol/mol)]. Dietary intake of protein, fat, carbohydrates, cholesterol, and salt in the intervention group demonstrated significant reduction, while the intake of dietary fiber significantly increased after the dietary education. Simple dietary education of ‘eating vegetables before carbohydrates’ presented by dietitians achieved good glycemic control after a 5-year period in outpatients with T2DM at primary care clinic.
本回顾性队列研究旨在评估初级保健诊所中，营养师主导的医学营养治疗（先吃蔬菜后吃碳水化合物）对 2 型糖尿病（T2DM）门诊患者血糖控制的 5 年随访效果。比较了 138 例接受营养师主导的医学营养治疗（干预组）和 104 例未接受营养师主导营养治疗（对照组）的患者，评估血糖控制、血清脂质、血压和糖尿病并发症，随访时间为 5 年。干预组的每位患者均接受营养师提供的以食物顺序（先吃蔬菜后吃碳水化合物）为重点的饮食教育。干预组的 HbA1c 在 5 年后显著改善[8.5 ± 1.7%（69 mmol/mol）降至 7.6 ± 1.1%（59 mmol/mol），p < 0.001]，而对照组无变化[7.9 ± 1.2%（62 mmol/mol）至 8.0 ± 1.2%（63 mmol/mol）]。干预组的蛋白质、脂肪、碳水化合物、胆固醇和盐的饮食摄入量显著减少，而膳食纤维的摄入量在饮食教育后显著增加。营养师提供的简单饮食教育“先吃蔬菜后吃碳水化合物”可使初级保健诊所的 T2DM 门诊患者在 5 年内血糖得到良好控制。
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