Parillo M, Giacco R, Ciardullo A V, Rivellese A A, Riccardi G
Institute of Internal Medicine and Metabolic Diseases, Medical School, University of Naples Federico II, Italy.
Diabetes Care. 1996 May;19(5):498-500. doi: 10.2337/diacare.19.5.498.
To compare the effects of a nigh-carbohydrate diet on blood glucose and plasma lipids in NIDDM patients with either mild or severe glucose intolerance.
A crossover design with a 15-day intervention diet was used. Eighteen patients were separated into two groups on the basis of hypoglycemic treatment (diet, n = 9, or diet plus glibenclamide, n = 9) and were assigned to a 15-day treatment with a high-carbohydrate/low-fiber diet containing 60% energy from carbohydrate and 20% from fat or a low-carbohydrate/low-fiber diet with 40% energy from carbohydrate and 40% from fat and then crossed over to the other diet for 15 more days.
The high-carbohydrate diet produced a significant increase in postprandial blood glucose in patients on glibenclamide (13.6 +/- 1.4 vs. 11.0 +/- 1.8 mmol/l, P < 0.002, while no difference was recorded in the group on diet alone (9.7 +/- vs. 8.9 +/- 0.6 mmol/l). Postprandial insulin levels were significantly higher after the high-carbohydrate diet in the group on diet along (248 +/- 32 vs. 192 +/- 28 pmol/l, P < 0.01), while no significant differences were observed in the other group (226 +/- 19 vs. 202 +/- 24 pmol/l) The high-carbohydrate diet also induced a significant increase in fasting plasma triglyceride concentrations in both groups (1.36 +/- 0.2 vs. 1.12 +/- 0.2 mmol/l, P < 0.05 and 1.4 +/- 0.3 vs. 1.1 +/- 0.1 mmol/l, P < 0.05). No differences were observed in fasting plasma cholesterol and HDL.
The effects of the high-carbohydrate diet on blood glucose control in NIDDM patients differ according to severity of glucose intolerance.
比较高碳水化合物饮食对轻度或重度葡萄糖耐量异常的非胰岛素依赖型糖尿病（NIDDM）患者血糖及血脂的影响。
采用交叉设计，进行为期15天的干预饮食。18例患者根据降糖治疗方法分为两组（单纯饮食治疗组，n = 9；饮食加格列本脲治疗组，n = 9），分别接受为期15天的高碳水化合物/低纤维饮食（碳水化合物供能占60%，脂肪供能占20%）或低碳水化合物/低纤维饮食（碳水化合物供能占40%，脂肪供能占40%），之后交叉接受另一种饮食治疗15天。
高碳水化合物饮食使格列本脲治疗组患者餐后血糖显著升高（13.6±1.4 vs. 11.0±1.8 mmol/L，P<0.002），而单纯饮食治疗组未观察到差异（9.7± vs. 8.9±0.6 mmol/L）。单纯饮食治疗组高碳水化合物饮食后餐后胰岛素水平显著升高（248±32 vs. 192±28 pmol/L，P<0.01），另一组未观察到显著差异（226±19 vs. 202±24 pmol/L）。高碳水化合物饮食还使两组患者空腹血浆甘油三酯浓度显著升高（1.36±0.2 vs. 1.12±0.2 mmol/L，P<0.05；1.4±0.3 vs. 1.1±0.1 mmol/L，P<0.05）。空腹血浆胆固醇和高密度脂蛋白未观察到差异。
高碳水化合物饮食对NIDDM患者血糖控制的影响因葡萄糖耐量异常的严重程度而异。
