Fiedler Michél, Müller Nicolle, Kloos Christof, Kramer Guido, Kellner Christiane, Schmidt Sebastian, Wolf Gunter, Kuniß Nadine
Department of Internal Medicine III, Jena University Hospital, 07747 Jena, Germany.
Outpatient Healthcare Center MED:ON MVZ, 99096 Erfurt, Germany.
J Clin Med. 2024 Aug 29;13(17):5126. doi: 10.3390/jcm13175126.
: The aim of this study was to investigate the feasibility and practicability of repeated three-day sequences of a hypocaloric oat-based nutrition intervention (OI) in insulin-treated outpatients with type 2 diabetes and severe insulin resistance. : A randomized, two-armed pilot study was conducted with three months of intervention and three months follow-up with 17 participants with insulin resistance (≥1 IU/kg body weight). Group A ( = 10) performed one sequence of OI; Group B ( = 7) performed two sequences monthly. A sequence was 3 consecutive days of oat consumption with approximately 800 kcal/d. The main objective was to assess feasibility (≥70% completers) and practicability regarding performance aspects. Biomedical parameters such as HbA1 c were observed. To evaluate the state of health, a standardized questionnaire was used (EQ-5 D). : OI was feasible (13/17 completer participants (76.5%): 70.0% Group A, 85.7% Group B). Individually perceived practicability was reported as good by 10/16 participants (62.5%). Total insulin dosage decreased from 138 ± 35 IU at baseline to 126 ± 42 IU after OI ( = 0.04) and 127 ± 42 IU after follow-up ( = 0.05). HbA1 c was lower after OI (-0.3 ± 0.1%; = 0.01) in all participants. Participants in Group B tended to have greater reductions in insulin (Δ-19 IU vs. Δ-4 IU; = 0.42) and weight loss (Δ-2.8 kg vs. Δ-0.2 kg; = 0.65) after follow-up. Severe hypoglycemia was not observed. EQ-5 D increase not significantly after follow-up (57.2 ± 24.0% vs. 64.7 ± 21.5%; = 0.21). : The feasibility and practicability of OI in outpatients were demonstrated. OI frequency appears to correlate with insulin reduction and weight loss. Proper insulin dose adaptation during OI is necessary. Presumably, repeated OIs are required for substantial beneficial metabolic effects.
本研究的目的是调查在接受胰岛素治疗的2型糖尿病和严重胰岛素抵抗门诊患者中,基于燕麦的低热量营养干预(OI)重复三日疗程的可行性和实用性。
开展了一项随机双臂试点研究,对17名胰岛素抵抗(≥1 IU/kg体重)参与者进行了为期三个月的干预和三个月的随访。A组(n = 10)进行了一个疗程的OI;B组(n = 7)每月进行两个疗程。一个疗程是连续3天食用燕麦,每天约800千卡。主要目的是评估可行性(完成率≥70%)和性能方面的实用性。观察了诸如糖化血红蛋白(HbA1c)等生物医学参数。为评估健康状况,使用了标准化问卷(EQ-5D)。
OI是可行的(13/17名完成干预的参与者(76.5%):A组为70.0%,B组为85.7%)。10/16名参与者(62.5%)报告个人感觉实用性良好。总胰岛素剂量从基线时的138±35 IU降至OI后的126±42 IU(P = 0.04),随访后为127±42 IU(P = 0.05)。所有参与者在OI后糖化血红蛋白降低(-0.3±0.1%;P = 0.01)。随访后,B组参与者的胰岛素降低幅度更大(Δ-19 IU对Δ-4 IU;P = 0.42),体重减轻幅度更大(Δ-2.8 kg对Δ-0.2 kg;P = 0.65)。未观察到严重低血糖。随访后EQ-5D升高不显著(57.2±24.0%对64.7±21.5%;P = 0.21)。
证明了OI在门诊患者中的可行性和实用性。OI频率似乎与胰岛素降低和体重减轻相关。OI期间适当调整胰岛素剂量是必要的。大概需要重复进行OI才能产生显著的有益代谢效应。