营养师支持的饮食干预可使 2 型糖尿病患者的饮食发生有利变化：一项随机对照试验。
Dietitian-supported dietary intervention leads to favorable dietary changes in patients with type 2 diabetes: A randomized controlled trial.
机构信息
Department of Clinical Nutrition, Jichi Medical University Hospital, Shimotsuke, Tochigi, Japan.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Jichi Medical University, Shimotsuke, Tochigi, Japan.
出版信息
J Diabetes Investig. 2022 Dec;13(12):1963-1970. doi: 10.1111/jdi.13890. Epub 2022 Aug 30.
AIMS/INTRODUCTION: It remains to be fully elucidated whether nutrition education by dietitians can lead to specific positive changes in the food choices of patients with diabetes.
MATERIALS AND METHODS
A total of 96 patients with type 2 diabetes and diabetic kidney disease were randomly assigned to the intensive intervention group that received nutritional education at every outpatient visit and the control group that received nutritional education once a year. The total energy intake, energy-providing nutrients and 18 food groups were analyzed at baseline, and 1 and 2 years after the intervention in 87 patients. Furthermore, the relationship between the changes in hemoglobin A1c, body composition and changes in the total energy or energy-producing nutrient intake was analyzed in 48 patients who did not use or change hypoglycemic agents during the study period.
RESULTS
The total energy intake, carbohydrates, cereals, confections, nuts and seeds, and seasonings significantly decreased, and fish and shellfish intake significantly increased during the study period in the intensive intervention group, whereas these changes were not observed in the control group. The decrease in the total energy intake and carbohydrates after 2 years was significantly greater in the intensive intervention group than in the control group. The change in the total energy and carbohydrate intake showed a significant positive correlation with that in muscle mass. The multivariate analysis showed that the decrease in total energy intake was independently associated with that in muscle mass.
CONCLUSION
Dietitian-supported intensive dietary intervention helps improve the diet of patients with type 2 diabetes.
目的/引言：营养师提供的营养教育是否能导致糖尿病患者的食物选择发生具体的积极变化，仍有待充分阐明。
材料与方法
共有 96 例 2 型糖尿病伴糖尿病肾病患者被随机分配到强化干预组，该组在每次门诊就诊时接受营养教育，对照组则每年接受一次营养教育。在 87 例患者中，在基线时以及干预 1 年和 2 年后分析了总能量摄入、供能营养素和 18 种食物组。此外，在研究期间未使用或改变降糖药物的 48 例患者中，分析了血红蛋白 A1c、身体成分以及总能量或供能营养素摄入变化之间的关系。
结果
在强化干预组中，总能量摄入、碳水化合物、谷物、糖果、坚果和种子以及调味料显著减少，而在对照组中则没有观察到这些变化。与对照组相比，强化干预组在 2 年后的总能量摄入和碳水化合物减少更为显著。总能量和碳水化合物摄入的变化与肌肉量的变化呈显著正相关。多元分析显示，总能量摄入的减少与肌肉量的减少独立相关。
结论
营养师支持的强化饮食干预有助于改善 2 型糖尿病患者的饮食。
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