健康行动干预对改善2型糖尿病患者饮食质量和血糖控制的有效性：随机临床试验的系统评价

Effectiveness of Health Action Interventions in Enhancing Diet Quality and Glycemic Control Among Individuals With Type 2 Diabetes Mellitus: A Systematic Review of Randomized Clinical Trials.

作者信息

Santos Beatriz C, Alves Luana F, Rocha Vivianne S, Hernandez-Ruiz Ángela, Silva Ana Mara O, Pires Liliane V

机构信息

Postgraduate Program in Nutrition Sciences, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil.

Nutritional Biochemistry Laboratory, Department of Nutrition, Center for Biological and Health Sciences, Federal University of Sergipe, São Cristóvão, Sergipe 49107-230, Brazil.

出版信息

Nutr Rev. 2025 Mar 1;83(3):e1115-e1127. doi: 10.1093/nutrit/nuae071.

DOI:10.1093/nutrit/nuae071

PMID:38894637

Abstract

CONTEXT

Diet quality is directly related to glycemic control in individuals with type 2 diabetes mellitus (T2DM). The use of dietary indices can provide a comprehensive understanding of the relationship between diet quality and clinical outcomes.

OBJECTIVE

The aim was to evaluate the relationship between diet quality, measured using dietary indices, and its impact on improving glycemic control in individuals with T2DM through health interventions.

DATA SOURCE

This study was conducted using 6 databases, including Web of Science, MEDLINE (via PubMed), Embase, Bireme, Scopus, and Cumulative Index to Nursing and Allied Health Literature (CINAHL), as well as the gray literature (Google Academic).

DATA EXTRACTION

Randomized clinical trials that evaluated the effectiveness of health interventions in adult and older adult individuals with T2DM and presented data on diet quality evaluated using dietary indices and the percentage of glycated hemoglobin (%HbA1c) were included.

DATA ANALYSIS

A total of 3735 articles were retrieved, 4 of which were included in the study selection stages. The quality indices assessed in the studies were the Alternate Healthy Eating Index (AHEI), Healthy Eating Index-2010 (HEI-2010), Diet Quality Index-International (DQI-I), and Diet Quality Index-Revised (DQI-R). A reduction in %HbA1c was observed in 2 studies, which correlated with the AHEI and DQI-I scores in the intervention groups. The approach of using food labels to improve diet quality reduced %HbA1c by 0.08% in the intervention group compared with the control group. Only 1 study found no significant association between the DQI-R index and %HbA1c. Additionally, negative correlations were observed between body weight and the AHEI and DQI-I scores.

CONCLUSION

Health interventions improved diet quality, glycemic control, and weight loss in individuals with T2DM.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO no. CRD42023430036.

摘要

背景

饮食质量与2型糖尿病（T2DM）患者的血糖控制直接相关。使用饮食指数可以全面了解饮食质量与临床结局之间的关系。

目的

旨在评估通过健康干预措施，使用饮食指数衡量的饮食质量及其对改善T2DM患者血糖控制的影响之间的关系。

数据来源

本研究使用了6个数据库，包括科学网、MEDLINE（通过PubMed）、Embase、Bireme、Scopus和护理及相关健康文献累积索引（CINAHL），以及灰色文献（谷歌学术）。

数据提取

纳入评估健康干预措施对成年和老年T2DM患者有效性的随机临床试验，并呈现使用饮食指数评估的饮食质量数据和糖化血红蛋白百分比（%HbA1c）。

数据分析

共检索到3735篇文章，其中4篇纳入研究选择阶段。研究中评估的质量指数为替代健康饮食指数（AHEI）、2010年健康饮食指数（HEI-2010）、国际饮食质量指数（DQI-I）和修订版饮食质量指数（DQI-R）。2项研究观察到%HbA1c降低，这与干预组的AHEI和DQI-I得分相关。与对照组相比，使用食品标签改善饮食质量的方法使干预组的%HbA1c降低了0.08%。只有1项研究发现DQI-R指数与%HbA1c之间无显著关联。此外，观察到体重与AHEI和DQI-I得分之间存在负相关。