BMJ:碳水化合物限制饮食对II型糖尿病的治疗效果

2021-01-15 MedSci原创 MedSci原创

低碳水化合物饮食对II型糖尿病患者病情控制有积极作用,特别是在适当的药物干预治疗基础上

饮食结构调整是治疗糖尿病的重要辅助手段,在胰岛素广泛临床应用之前,糖尿病患者往往需要严格的碳水化合物限制饮食。近日研究人员开展系统综述及荟萃分析,考察了低碳水化合物饮食对II型糖尿病的治疗效果
 
研究人员收集了截至2020年8月,CENTRAL, Medline, Embase, CINAHL, CAB等数据库收录的相关研究。评估了持续至少12周的低碳水化合物饮食(LCDs,碳水化合物摄入量低于130g/天或在每日不超过2000Kcal的饮食摄入中,碳水化合物所提供的的能量占比低于26%)和极低碳水化合物饮食(VLCDs,碳水化合物所提供的能量占比低于10%)对II型糖尿病成年患者的疗效及安全性。研究的主要终点为糖尿病缓解,定义HbA1c低于6.5%或空腹血糖低于7.0 mmol/L、体重降低、HbA1c水平、空腹血糖以及不良事件,次要终点包括生活质量及实验室生化数据。
 
总计23个研究,1357名患者数据纳入本次荟萃分析,40.6%的研究结论偏倚风险较低。研究发现,持续6个月的饮食控制,相比于正常饮食患者,LCD人群的糖尿病缓解率较高(HbA1c <6.5%的患者比例:LCD vs正常饮食组:57% vs 31%,但在无糖尿病药物治疗的情况下,LCD的效果降低,而胰岛素治疗人群,接受LCD后的效果显著),但当LCD持续12个月时,其效果下降。6个月时,LCD组在体重降低、甘油三酯降低和提高胰岛素敏感性方面的效果较为显著,但12个月时下降。有可靠的数据表明,6个月时,VLCD在降低体重方面的效果不如LCD,患者依从性可能是解释VLCD效果不佳的主要因素,但对于VLCD高依从性人群,其减重效果优于低依从性人群。饮食控制对患者生活质量、不良事件以及血脂水平的影响较少。
 
研究认为,低碳水化合物饮食对II型糖尿病患者病情控制有积极作用,特别是在适当的药物干预治疗基础上
 
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    2021-06-24 gaoxiaoe
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likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0c85453032, createdName=刘耀玲, createdTime=Fri Jan 15 13:58:24 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
    2021-01-18 kun

    饮食重要

    0

  5. 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likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0c85453032, createdName=刘耀玲, createdTime=Fri Jan 15 13:58:24 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
  6. 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likeNumber=167, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=e0c85453032, createdName=刘耀玲, createdTime=Fri Jan 15 13:58:24 CST 2021, time=2021-01-15, status=1, ipAttribution=)]
    2021-01-17 yuanming9
  7. 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    2021-01-16 神盾医疗局局长Jack

    低碳水化合物饮食对II型糖尿病患者病情控制有积极作用,特别是在适当的药物干预治疗基础上

    0

  8. 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  9. 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    2021-01-15 margery

    主要是要靠坚持

    0

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    2021-01-15 刘耀玲

    厉害

    0

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