摘要
目的探讨低血糖生成指数(GI)饮食辅助司美格鲁肽治疗成年肥胖2型糖尿病(T2DM)患者糖脂代谢及体质量指数(BMI)控制的影响。方法本研究采用前瞻性随机对照设计,纳入2023年1月~2025年1月新疆维吾尔自治区人民医院就诊的116例成年肥胖T2DM患者作为研究对象,通过随机数字表法将受试者均分为观察组与对照组,各58例。对照组给予常规干预和司美格鲁肽治疗,观察组在此基础上给予低GI饮食辅助治疗,均连续治疗3个月。比较两组患者治疗前后的糖脂代谢指标、BMI以及健康调查量表(SF-36)评分。结果治疗后,观察组的空腹血糖[(6.45±0.83)mmol/L vs.(7.63±0.96)mmol/L]、糖化血红蛋白[(6.57±0.68)%vs.(7.38±0.82)%]、餐后2 h血糖[(8.23±1.61)mmol/L vs.(10.67±1.95)mmol/L]、总胆固醇[(3.92±0.47)mmol/L vs.(4.83±0.54)mmol/L]、甘油三酯[(2.32±0.23)mmol/L vs.(2.89±0.36)mmol/L]、低密度脂蛋白胆固醇[(3.47±0.65)mmol/Lvs.(3.98±0.72)mmol/L]、胰岛素抵抗指数[(2.12±0.33)vs.(2.75±0.39)]、BMI[(26.57±1.36)kg/m^(2)vs.(28.43±1.52)kg/m^(2)]均低于对照组,差异均有统计学意义(t=7.081、5.791、7.349、9.681、10.162、4.004、9.392、6.945,P<0.05)。高密度脂蛋白胆固醇[(1.48±0.42)mmol/L vs.(1.31±0.39)mmol/L]、空腹C肽[(4.87±0.63)ng/mL vs.(3.26±0.58)ng/mL]、SF-36各维度评分[精神健康(83.22±6.74)分vs.(74.29±6.13)分、生理职能(82.26±5.63)分vs.(77.68±5.34)分、活力(86.49±6.87)分vs.(81.33±6.56)分、情感职能(79.52±5.32)分vs.(73.47±4.69)分、躯体疼痛(85.27±6.68)分vs.(81.95±6.27)分、社会功能(78.46±5.36)分vs.(71.67±4.82)分、总体健康(84.17±5.67)分vs.(79.42±5.31)分、生理功能(80.83±5.96)分vs.(74.69±5.27)分]均高于对照组,差异均有统计学意义(t=2.259、14.319、7.465、4.495、4.137、6.497、2.760、7.174、4.657、5.878,P<0.05)。结论低GI饮食辅助司美格鲁肽治疗成年肥胖T2DM患者能有效改善其糖脂代谢水平,控制体质量,提高生活质量水平。
Objective To investigate the effects of low glycemic index(GI)diet on glucose and lipid metabolism and body mass index(BMI)control in adult obese patients with type 2 diabetes mellitus(T2DM).Methods In this study,a prospective randomized controlled design was used to include 116 adult obese T2DM patients who were treated from January 2023 to January 2025 as subjects.The subjects were divided into observation group and control group by random number table method,58 cases each.The control group was given routine intervention and semaglutide treatment,and the observation group was given low GI diet adjuvant therapy on this basis.Both groups were treated continuously for 3 months.The glucose and lipid metabolism indexes,BMI and health survey scale(SF-36)scores before and after treatment were compared between the two groups.Results After treatment,the fasting blood glucose[(6.45±0.83)mmol∕L vs.(7.63±0.96)mmol∕L],glycosylated hemoglobin[(6.57±0.68)%vs.(7.38±0.82)%],2 h postprandial blood glucose[(8.23±1.61)mmol∕L vs.(10.67±1.95)mmol∕L],total cholesterol[(3.92±0.47)mmol∕L vs.(4.83±0.54)mmol∕L],triglyceride[(2.32±0.23)mmol∕L vs.(2.89±0.36)mmol∕L],low-density lipoprotein cholesterol[(3.47±0.65)mmol∕L vs.(3.98±0.72)mmol∕L],insulin resistance index[(2.12±0.33)vs.(2.75±0.39)],and BMI[(26.57±1.36)kg∕m^(2) vs.(28.43±1.52)kg∕m^(2)]of the observation group were all lower than those of the control group(t=7.081,5.791,7.349,9.681,10.162,4.004,9.392,6.945,all P<0.05).while the high-density lipoprotein cholesterol[(1.48±0.42)mmol∕L vs.(1.31±0.39)mmol∕L],fasting C-peptide[(4.87±0.63)ng∕mL vs.(3.26±0.58)ng∕mL],and scores of all dimensions of the SF-36[mental health(83.22±6.74)points vs.(74.29±6.13)points,role-emotional(82.26±5.63)points vs.(77.68±5.34)points,vitality(86.49±6.87)points vs.(81.33±6.56)points,emotional function(79.52±5.32)points vs.(73.47±4.69)points,bodily pain(85.27±6.68)points vs.(81.95±6.27)points,social function(78.46±5.36)points vs.(71.67±4.82)points,general health(84.17±5.67)points vs.(79.42±5.31)points,physical function(80.83±5.96)points vs.(74.69±5.27)points]of the observation group were all higher than those of the control group(t=2.259,14.319,7.465,4.495,4.137,6.497,2.760,7.174,4.657,5.878,all P<0.05).Conclusion Low GI diet assisted with semaglutide in the treatment of obese T2 DM patients in adults can effectively improve their glucose and lipid metabolism,control weight and improve the quality of life.
作者
李园
马婷
杨媛
LI Yuan;MA Ting;YANG Yuan(Department of Comprehensive Health,Xinjiang Uygur Autonomous Region People's Hospital,Urumqi 830000,China)
出处
《中华保健医学杂志》
2025年第6期1033-1037,共5页
Chinese Journal of Health Care and Medicine
基金
新疆维吾尔自治区人民医院院内项目(20240239)。
