整体心理营养方法在肥胖和饮食功能失调的2型糖尿病患者管理中的疗效
Efficacy of the holistic, psychonutritional approach of in the management of type 2 diabetes among patients with obesity and dysfunctional eating.
作者信息
Barana Luisa, Colleluori Georgia, Sulpizi Maria Teresa, Ortenzi Kathleen, Farano Luca, Fanelli Carmine Giuseppe, Calafiore Riccardo, Dalla Ragione Laura, Pampanelli Simone
机构信息
Section of Endocrinology and Metabolism, Department of Medicine, University of Perugia, Piazzale Gambuli 1, 06129 Perugia, Italy.
Centro DAI e Obesità of Città della Pieve, USL Umbria1 Città della Pieve, Via Beato Giacomo Villa 1, 06062 Città della Pieve, PG Italy.
出版信息
J Diabetes Metab Disord. 2022 Jul 22;21(2):1883-1893. doi: 10.1007/s40200-022-01085-1. eCollection 2022 Dec.
PURPOSE
Dysfunctional eating is strongly associated with obesity and worsens type 2 diabetes (T2DM) outcomes. The aim of this study was to investigate the effectiveness of the psycho-nutritional treatment (PNT) of " of Città della Pieve on weight loss and glucose management in dysfunctional eaters with obesity and T2DM.
METHODS
PNT includes psychotherapeutical, nutritional, physical and social activities. Subjects with obesity, T2DM and dysfunctional eating habits who completed the 8 weeks residential program between 2010 and 2019 were compared with obese, T2DM, dysfunctional eaters who underwent to a conventional, hospital-based, nutritional treatment (CT). Anthropometric variables, glucolipid panel, and body composition were assessed at baseline and at the end of the program. Weight and HbA1c were also measured after one year from the completion.
RESULTS
Sixty-nine patients completed the PNT and reduced weight (-7 ± 3.2%; < 0.001), BMI (-7 ± 3.1%; < 0.001), and triglycerides, AST, GGT and ALT ( ≤ 0.008); glycemic control improved (HbA1c: -1.1 ± 1.5%, mean fasting glucose: -41 ± 46 mg/dl, < 0.001). Eleven% of subjects requiring diabetes medications at baseline discontinued the therapy. In the insulin treated group (49%), mean daily units were halved (-32.6 ± 26.0, < 0.001). At one year, weight loss (-6 ± 7.4%, < 0.001) and HbA1c reduction (-0.52 ± 1.4%, p = 0.029) persisted. Fifty-five patients completed the CT: HbA1c reduced (p = 0.02), but weight (-0.6 ± 3.7%), BMI (-0.7 ± 3.8%), and insulin units' reduction (-2.5 ± 11.7, p = 0.20) were lower compared to the PNT.
CONCLUSION
PNT is effective in improving T2DM management in patients with obesity and dysfunctional eating.
目的
功能失调性饮食与肥胖密切相关，并会使2型糖尿病（T2DM）的病情恶化。本研究旨在调查“奇塔德拉皮耶韦”心理营养疗法（PNT）对肥胖且患有T2DM的功能失调性饮食者体重减轻和血糖管理的有效性。
方法
PNT包括心理治疗、营养、身体和社交活动。将2010年至2019年间完成8周住院项目的肥胖、患有T2DM且有功能失调饮食习惯的受试者，与接受传统医院营养治疗（CT）的肥胖、患有T2DM的功能失调性饮食者进行比较。在基线时和项目结束时评估人体测量变量、糖脂指标和身体成分。在完成项目一年后还测量了体重和糖化血红蛋白（HbA1c）。
结果
69名患者完成了PNT，体重减轻（-7±3.2%；<0.001）、体重指数（BMI）降低（-7±3.1%；<0.001），甘油三酯、谷草转氨酶（AST）、γ-谷氨酰转肽酶（GGT）和谷丙转氨酶（ALT）降低（≤0.008）；血糖控制得到改善（HbA1c：-1.1±1.5%，平均空腹血糖：-41±46mg/dl，<0.001）。基线时需要糖尿病药物治疗的受试者中有11%停止了治疗。在胰岛素治疗组（49%）中，平均每日胰岛素用量减半（-32.6±26.0，<0.001）。一年后，体重减轻（-6±7.4%，<0.001）和HbA1c降低（-0.52±1.4%，p=0.029）持续存在。55名患者完成了CT：HbA1c降低（p=0.02），但与PNT相比，体重（-0.6±3.7%）、BMI（-0.7±3.8%）和胰岛素用量减少（-2.5±11.7，p=0.20）较低。
结论
PNT对改善肥胖且有功能失调性饮食的患者的T2DM管理有效。
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